Imaging/ Radiology (Ultrasound, Fibroscan, CT, MRI)
Diagnostic imaging, or pictures, can play a role in evaluating the health of the liver. Imaging includes various techniques for examining liver disease or scarring including ultrasound sonography, liver elastography such as Fibroscan, Computed Tomography (CT scan), and Magnetic Resonance Imagining (MRI scanner).
Ultrasound
The ultrasound device uses sound waves to produce a pattern of echoes as they bounce off organs in your body. The echoes create a black-and-white picture of your liver and other organs in the abdomen. Scarring or tumors produce echoes that are different from the echoes made by healthy tissues and may be visible in the ultrasound pictures. Ultrasound technology may be used to aid in monitoring liver health as well as being used for liver cancer surveillance. Talk to your provider about liver cancer surveillance and about measuring liver and spleen size along with portal vein diameter during your ultrasound study.
Liver Elastography (FibroScan)
A FibroScan device uses special ultrasound technology that measures liver stiffness, or hardness that results from liver disease and scarring. It also measures the amount of fat in the liver. Liver stiffness is measured in kilopascals (kPA) and is used to generate a fibrosis score. Liver fat is measured in decibels per meter (dB/m) and is used to calculate the percentage of fat in the liver. These scores can be used to initially help evaluate the liver and later compare fibrosis and fat over time. For additional information, refer to Understanding Your Liver Elastography (FibroScan) Results.
CT Scan
The CT (computed tomography) scanner is an x-ray machine that is linked to a computer. The CT scanner takes a series of detailed pictures from different angles around your body. The computer then combines these pictures to show the size, shape, and position of tumors in the liver or other parts of the abdomen. Some medical centers now use spiral or helical CT scanners, which are faster, use lower doses of radiation, and produce more detailed pictures than standard CT scans.
MRI
The MRI (magnetic resonance imaging) scanner uses radio waves and strong magnets to make detailed pictures of soft tissues inside your body. MRI scanners do not use x-rays. Sometimes the technician will inject a dye into your vein to help see details more clearly. MRI scans are used to examine the liver as well as blood vessels in and around the liver. Sometimes MRI scans can show the difference between a benign (not cancerous) tumor and a malignant (cancerous) one.
*The machine and process of having a Fibroscan looks similar to an ultrasound. Here is a short video looking at the machine and the process. If you have a Fibroscan report, use this guide from the Memorial Sloan Kettering Hospital to learn if you have hepatitis B related fibrosis or fatty liver disease. Fibroscan requires the use of a specific machine and may not be available everywhere or may not be covered under your health insurance.