What is Fibroscan?
Fibroscan or transitional elastography is a technique that allows to assess the degree of hepatic fibrosis as well as the quantification of hepatic fat. It is a non-invasive, fast, reliable and reproducible scan. Elastography is particularly useful as an alternative to biopsy.
Fibroscan is useful both for the initial diagnosis of the disease and for its follow-up and evolution.
Advantages of Fibroscan
In liver diseases, regardless of their cause, inflammation generally occurs, which causes cell destruction, so that later repair phenomena develop, with progressive accumulation of collagenous fiber”.
The usefulness of assessing the degree of fibrosis serves both for the initial diagnosis of the disease and for its follow-up and evolution. For years, this evaluation and quantification of liver fibrosis has been carried out by means of liver biopsy. “It consists of the analysis of cells from a small sample of liver, obtained by puncture through the skin (percutaneous) or through the intrahepatic veins (transjugular)”.
In spite of having been the most widely used technique, liver biopsy has disadvantages. On the one hand, it requires admission of the patient for at least twelve to twenty-four hours and, on the other hand, difficulties in the evaluation, since the distribution of the hepatic fibrosis is diffuse but not homogeneous.
Liver biopsy can present various complications, most of them mild, such as pain at the puncture site, in the hepatic area or at the neck or shoulder level. But there may also appear more serious ones such as hemorrhage, pneumothorax, hemothorax, perforation of any organ, biliary peritonitis, etc., and even death.
Preparation for Fibroscan
The patient should come to the consultation with a two-hour fasting period. The patient lies on a stretcher with the right arm raised and placed behind the nape of the neck. The measurements are taken with a transducer or probe, to which a gel is placed on the surface, which is placed intercostally over the right hepatic lobe. The patient does not feel anything during the scan. We have M and XL probe for obese patients. A minimum of 10 measurements are performed.
What is Fibroscan performed for?
Diagnosis and follow-up of chronic hepatitis C virus (HCV) hepatitis, chronic hepatitis B virus (HBV) hepatitis, hepatitis C virus and HIV co-infection, alcoholic liver disease, non-alcoholic hepatic (fatty liver) steatosis, chronic cholestatic diseases, liver cirrhosis and follow-up of pre- and post-liver transplant patients are some of the validated uses of elastography.
Significance of abnormal results
Its measurement allows to know the stage of liver fibrosis (hardness), from a mild stage to the most advanced (cirrhosis).
Fatty liver, a new epidemic
Non-alcoholic hepatic steatosis (NASH) or fatty liver is currently the leading cause of a sustained increase in transaminases. An increase in the number of new cases is expected in relation to dietary changes in the population and the increase in the metabolic syndrome that associates obesity, arterial hypertension, diabetes and dyslipidemia (increase in cholesterol and/or triglycerides).
The fibroscan, in addition to measuring fibrosis, also includes the measurement of the CAP (Control Attenuation Parameter) which quantifies the deposit of fat in the liver, which is important for an early diagnosis of this pathology. It should be remembered that this test is always performed by a specialist in the digestive system.
Advances: fibroscan avoids the need for biopsies
These limitations of biopsy have led to the search for other diagnostic methods for liver fibrosis. The most important advance has come with the development and practical application of transitional elastography (Fibroscan).
Elastography is based on the measurement of the stiffness or elasticity of a tissue. It is a non-invasive technique, does not involve any discomfort for the patient, does not require hospital admission and provides immediate results. The volume explored is at least one hundred times greater than that of a liver biopsy.