Liver elastography is applied to assess a level of liver fibrosis and steatosis. It works very well in the diagnosis and follow-up observation of patients with hepatitis B and C.

Excessive liver fibrosis has serious health consequences, ultimately involving the replacement of normal parenchyma in the organ with connective tissue. It results in: functional disturbance of the bile duct, impaired outflow of bile, damage to hepatocytes, causing their necrosis and cirrhosis. Liver fibrosis is caused by prolonged exposure to agents which damage liver cells. These agents include viruses, alcohol, autoimmune diseases (e.g. primary sclerosing cholangitis), metabolic diseases (e.g. haemochromatosis, Wilson’s disease), certain medicines and toxins.

Steatosis is a disease in which fat deposits accumulate in liver cells, particularly as a result of alcohol abuse (alcoholic steatosis). It involves the accumulation of fat in liver cells (hepatocytes), which leads to its dysfunction. Further factors which contribute to the development of alcoholic liver disease are poor diet and genetic predisposition.

When alcohol consumption is stopped, the disease reverses after approx. 4-6 weeks. It progresses with continuous alcohol consumption, causing inflammation and cirrhosis in 35% of patients.

The most common symptoms are pain in the right hypochondrium near the liver, indigestion, heartburn, chronic fatigue, drowsiness, discomfort and a feeling of fullness in the stomach. And more serious ones, which may relate to liver disease, include yellow sclera or skin, itchy skin, weight loss and lack of appetite. These complaints may prompt patients to undergo a comprehensive hepatological diagnosis.

Liver elastography can be used not only for the diagnosis of patients with previously diagnosed liver disease, but also for screening tests aimed to detect asymptomatic liver damage with any aetiology at its early stage and to select people requiring in-depth hepatological diagnosis. Elastography itself is a non-invasive test (a low risk of complications), the patient is not hospitalised, there is neither local anaesthetic nor puncture made in the patient’s body. This is of utter importance because a lot of patients are afraid of invasive tests (liver biopsy) and abandon further diagnosis at the moment they find out that a liver biopsy is required.

The key indications for liver elastography are as follows:

  • hepatitis: viral (HCV, HBV), autoimmunological,
  • toxic liver damage,
  • alcoholic liver injury,
  • drug-induced liver damage,
  • liver steatosis.

It should not be performed in case of:

  • patients with pacemakers and other permanently connected electronic apparatus,
  • pregnant women,
  • patients with severe obesity and ascites,
  • organs other than the liver.

Benefits of liver elastography:

  • accurate assessment of liver damage,
  • exclusion or confirmation of cirrhosis,
  • required in the qualification of treating HCV infection,
  • potential better treatment planning.

Elastography with the use of this equipment is painless and the patient prepares for it in the same manner as he/she does for ultrasound testing (USG). Before the test, the patient should be fasting (the last meal should be consumed at least 6 hours prior to the examination).

Elastography stands for an examination which is similar to ultrasound imaging of the abdominal cavity. It is performed using specialised equipment dedicated to examining liver elastography. During such an examination, e.g. the doctor hepatologist or qualified nurse applies a special gel-coated ultrasound transducer to the examined liver area and analyses imaging on the monitor. The examination takes a short time (5-10 minutes), the patient feels only slight vibrations on his/her skin where the probe is applied.

The obtained result (elastogram) is a combination of colours from red to blue (256 shades), each of them corresponding to various tissue texture. Red colours show considerably soft areas, green colours – medium soft / hard and blue colours – hard (pathologically changed) areas. The result is obtained immediately after completion, allowing the liver to be assessed before and during treatment.

This examination can be performed without any problems several times a year on the same patient. On the grounds of all examinations (elastographic, biochemical and haematological), the doctor runs a comprehensive diagnosis of the liver condition.

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