FibroScan

Specialty of Gastroenterology

What is it?

A Fibroscan is a test that allows the assessment of hepatic fibrosis as well as the quantification of liver fat. It is a non-invasive technique that is fast and reliable. It is particularly useful as an alternative to a biopsy.   

  

Advantages of the Fibroscan     

Regardless of the cause, diseases affecting the liver generally cause inflammation which destroys cells. After this, repair techniques naturally develop with a progressive accumulation of collagen fibre.  

Knowing the degree of fibrosis is useful for diagnosing as well as monitoring and checking any disease progression. In the past this was traditionally done by a liver biopsy. A biopsy involves removing a small sample of the liver to analyse it by puncturing the skin or via the intrahepatic (transjugular) veins.

Despite having been the most widely used technique, a liver biopsy has its drawbacks. The patient must be at the hospital for between 12 and 24 hours, and the assessment is not always easy to read as liver fibrosis distribution is vague and not homogenous.

Complications may arise from a liver biopsy, however, most are mild such as pain at the puncture site, around the liver area, or in the neck or shoulder. More serious complications may include haemorrhage, pneumothorax (collapsed lung), haemothorax, organ perferation, biliary peritonitis, and in very extreme but rare cases, death.     

How can you prepare for it?

The patient should fast for two hours before the test. Once there, they lie down with their right arm raised and placed behind the neck. A transducer or probe is used to measure, and a gel is used on the surface. As it is a non-invasive test, the patient will not feel any discomfort. There are larger scanners available for obese patients. At least 10 measurements are made.  

Why would you do it? 

Fibroscan is quite commonly used in patients who have been diagnosed with or are being monitored for hepatitis C (HCV), chronic hepatitis due to hepatitis B (HBV), a combination of hepatitis C and HIV, alcoholic liver disease, hepatic steatosis (fatty liver) non-alcoholic, chronic cholestatic diseases, liver cirrhosis, and monitoring for pre- and post-liver transplant patients.   

What would a “bad” result mean?

Cases of non-alcoholic fatty liver disease and fatty liver are on the rise in the UK. An increase in the number of new cases is expected due to population diet changes and the increase in metabolic syndromes linked to obesity, high blood pressure, diabetes, and dyslipidaemia (increase in cholesterol and triglycerides).

As well as measuring fibrosis and the CAP (Controlled Attenuation Parameter), the fibroscan is able to quantify liver fat content, which is crucial for early diagnosis.

The test allows the physician to find out the stage of the liver fibrosis (hardness), from a mild stage to a more advanced stage (cirrhosis).

Who performs a Fibroscan?

Fibroscan tests are largely performed by hepatologists and gastroenterologists.

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