A liver elastography is a noninvasive test that a doctor can use to better understand the health of your liver. Depending on the results, the doctor may recommend additional tests or lifestyle modifications.
A liver elastography (LA) is a test your doctor can use to find out the health of your liver. It’s quick and noninvasive.
The results of the LA will help your doctor determine whether you have any scarring on your liver, caused by one or more liver conditions.
This article will explore the ins and outs of this procedure and what you can expect from your results.
An LA is noninvasive, meaning it happens outside your body. The test uses ultrasound or magnetic resonance imaging (MRI) to capture images.
These images can help a doctor diagnose conditions like fatty liver disease, fibrosis, or cirrhosis.
During an LA, low frequency waves are sent to your liver. The test then measures how the waves move through the liver. A healthy liver is more elastic, so the low frequency waves will move more slowly through healthy tissue. A damaged liver is stiffer because of scarring, so the low frequency waves will move more quickly.
Who’s a candidate for this test?
You may not be eligible for an LA if you:
- are pregnant or suspect you may be pregnant
- are claustrophobic (in the case of an MRI)
- have metal or a medical appliance in your body
- have swelling in your liver
- have fluid in your abdomen
- have right heart failure
- have significant obesity
- cannot lie flat
This is one of the most cost-effective ways to find out more about your liver. An LA is an outpatient procedure that takes a very short amount of time to perform. This is in contrast to a biopsy that requires hospitalization.
The cost of an LA will depend on many factors, including:
- whether you have public or private insurance
- the regional area where you live
- your doctor and health system
LAs are generally covered by insurance. If you are uninsured, an ultrasound may cost a few hundred dollars to a thousand dollars.
A few types of LAs exist. No matter what kind you have, it can be completed in a relatively short amount of time. After the test, you can return to your usual activities.
Prior to the LA, you may need to fast for up to 8 hours. You may also be asked to remove any jewelry or other metal on your body and change into a hospital gown. You’ll also be asked to complete a health history form.
Ultrasound elastography
Ultrasound elastography sends sound waves to your liver. Two different kinds are the FibroScan and Shear Wave. FibroScan uses transient elastography whereas Shear Wave uses two-dimensional shear wave elastography.
Both are comparable for diagnosing fibrosis and cirrhosis. A Shear Wave procedure may be more accurate for people with a body mass index above 40.
Here is what you can expect during an ultrasound:
- The technician performing the procedure will ask you to lie down face up.
- They will apply gel to the upper right side of your abdomen under your rib cage, where your liver is.
- They will use a special tool called a transducer on the gelled area to send sound waves to your liver for several minutes.
- The results will be recorded on a machine for a radiologist or doctor to analyze.
Magnetic resonance elastography (MRE)
This uses magnetic waves and sound waves. It occurs within an MRI machine. This is a large hollow tube with a wheeled bed.
Here is what you can expect during an MRE:
- The technician will position you on the bed and place a flat piece of equipment on the right side of your abdomen where your liver is. You might receive earplugs or headphones to block out the noise of the machine.
- They will roll you into the tube where you will need to lie still for 30 to 60 minutes.
- They will use the machine to send radio and magnetic waves to your liver to measure its elasticity.
- The technician may ask you over a loudspeaker to hold your breath for several seconds at certain times to capture clear images.
You cannot wear anything that contains metal during an MRE. This may include glasses, piercings, and removable medical and dental appliances.
LA results will indicate the health of your liver depending on how the waves from the ultrasound or MRE moved through your liver. The LA will capture different measurements or images, which a trained technician will use to help determine the condition of your liver.
LA results will be classified into one of five stages, depending on the level of scarring of your liver:
| Results | Stage |
|---|---|
| No scarring | Healthy liver |
| Minimal scarring | Early fibrosis |
| Moderate scarring that extends outside of your liver | Significant fibrosis |
| Scarring that is connected with other scarred areas | Severe fibrosis |
| Advanced scarring | Cirrhosis |
Your doctor may order more tests depending on the results. These may include a liver biopsy or lab tests.
Your doctor may recommend lifestyle modifications, medications, and other treatments for liver conditions, including:
- abstaining from alcohol
- eating a well-rounded diet
- exercising regularly
- managing other health conditions
Medical treatments may also be needed. Your doctor may want to monitor the progression of your condition with follow-up tests every few months or years.
Severe liver conditions may require surgery, a transplant, or chemotherapy and radiation.
An LA is a test that can help your doctor to assess the health of your liver. This procedure takes less than an hour and shouldn’t interfere with your daily activities. Your doctor can use this test to diagnose liver conditions and come up with a treatment plan if needed.
