Liver elastography
Brugsesteenweg
Rumbeke
Torhout
Menen
Until recently, as a liver specialist (hepatologist/gastroenterologist), people could only make a correct diagnosis of liver disease with a blood sample and a liver biopsy. The main disadvantage of the liver biopsy is that you have to pierce the wall of the upper body. This can lead to pain and a punctured lung (pneumothorax or collapsed lung). Newer techniques have been available for a number of years, which can in some cases prevent liver biopsy.
Fibroscan
One of the possible ways to assess liver damage is via a Fibroscan. This research determines how fast ultrasound waves propagate through the liver. The faster, the more damage to the liver and the less elastic the liver (high Fibroscan value of more than 12 kPa). The slower, the less damage to the liver and the more elastic your liver still is (low value on the Fibroscan).
In addition to the elasticity of the liver, the Fibroscan also says something about the degree of fatty liver disease. This is based on a second value: the CAP value. Because fat will interfere with the echo signal sent via the Fibroscan, the degree of 'disruption' of this signal is measured. From a value of more than 250 db/m, we speak of fatty liver disease.
ShearWave
A second way to measure liver stiffness or elasticity is via ShearWave technology. This uses a technique with sound waves: ultrasound images show a piece of liver that measures the elasticity of the liver. You also get a value expressed in kPa. Here, too, the higher the value, the less elastic and therefore the harder the liver, the more scar tissue on the liver.
Aim of the research
Preparation
For these examinations, you must be sober for 4 hours. This means that you must not have eaten or drunk anything for 4 hours before this study.
Execution
The implementation of the Fibroscan and the ShearWave is fairly similar. Both examinations are painless and take approximately 10 minutes. Both examinations are performed while lying on your back with the right arm behind the head. You may be asked to tilt your upper body slightly to the left side so that the space between the ribs on the right becomes a bit wider.
Gel is placed between the right ribs and the ultrasound probe is placed at the level of the right rib grid. A small amount is pushed between the ribs to achieve an optimal visualization of the liver.
The Fibroscan aims for 10 successful measurements; with the ShearWave, 3 to 4 measurements are sufficient.
Hospitalization
After the examination
Advantages and disadvantages
Side effects
Points of interest
It is possible that the Fibroscan or ShearWave give a false image or that the examinations are difficult to perform, e.g. in the presence of ascitic fluid, the presence of a lot of fat tissue in the abdomen, etc. Sometimes a liver biopsy is still necessary. The elastography is rather indicative, but cannot (yet) completely replace the liver biopsy.
