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Dr Allister J Grant

MB ChB(B'ham) PhD FRCP

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Fibroscan®

Fibroscan is a painless and non-invasive method for evaluating fibrosis/scarring in the liver. Fibroscan measures the stiffness or elasticity of the liver. It uses ultrasound to create waves and measures the speed at which these waves are reflected by the liver. The wave speed it used to determine liver stiffness. The more scarred the liver the stiffer it becomes and the stiffer the liver the quicker the waves are reflected.

Results are presented as a figure in kilopascals (kPa). The higher the figure, the stiffer and more scarred the liver. Results from Fibroscan should not be confused with fibrosis scores measured on other scoring systems. (click here for Fibroscan measurement interpretation)
This simple ten-minute test can detect liver damage but it does have some limitations. Fibroscan is very good at detecting a normal liver or a liver with extensive fibrosis (cirrhosis) but it is much less sensitive at detecting mild or moderate liver fibrosis. In addition it should be noted that Fibroscan will only measure liver fibrosis and will not help to discover the cause of the liver damage when this cannot be detected by blood tests. Under these circumstances a Liver biopsy may still be necessary. Fibroscan is however useful for following the progression of liver fibrosis over years and because it is non-invasive can be repeated regularly without risk (unlike liver biopsy).

In the early stages of liver disease, symptoms are rare and conventional ultrasounds may not be very useful. Many of the  risk factors which lead to liver disease are associated with unhealthy lifestyles. This is especially true of excess alcohol consumption and obesity (especially when associated with diabetes and high blood pressure).

 Your liver is tough however. It can withstand years of damage by repairing itself and protecting the rest of your body. However, it is often difficult for people to know whether their liver is damaged or not until it is in the advanced stages of scarring and by the time you notice any symptoms of liver disease, the damage may be done.



 


In Leicester Royal Infirmary we have recently managed to obtain (through Charitable Funds) a Fibroscan machine and we predict that this will cut the number of liver biopsies we do in the hepatology department by approximately half.

Links to useful sites: