This is off-topic, but a diagnosis of cirrhosis based on MRI only is hazardous. Many patients with 'early' cirrhosis have very few changes. As the severity of cirrhosis progresses, there are many characteristic signs. These include: Enlargement of the liver, enlargement of the caudate lobe with relative shrinking of the R lobe, changes in some caudate lobe width ratios, enlargement of the gallbladder fossa, nodularity of the liver surface, presence of regenerative nodules, distortion of the hepatic veins etc etc. These features can be seen just as well on Ultrasound or CT.
The real value of MRI is the diagnosis of regenerative nodules, the feature of cirrhosis. Contrast is required and T1 Gradient Echo imaging shows these nodules to be hypointense, but isodense after contrast. It is also possible to see dysplastic nodules or even HCC.
Obviously, ascites and portal hypertension can also be shown. At late stages, the shrunken scarred liver is obvious.
I've had several MRI's and it really takes some imagination to see any regenerative nodules. I certainly wouldn't diagnose cirrhosis on the basis of my findings. Just saying.........
Rubye said
Feb 26, 2015
Can a diagnosis of cirrhosis be safely made with a MRI?
That's how I was originally diagnosed 3 years ago and then I did the Fibrosure in order to be eligible for treatment and it indicated F3-F4 (not sure what the number was). I am wondering if the Fibrosure can be so inaccurate, then is there any solid basis for my cirrhosis diagnosis. I never had a biopsy.
mallani said
Feb 26, 2015
Hi Bill,
The Fibroscan measures liver stiffness by measuring the attenuation of an ultrasonic 'shear-wave'.
Fibrosure uses a formula based on biochemical parameters. One of these is the GGT level, which is known to fluctuate wildly. Many of us don't like it for this reason. The Fibrosure result is given as a number, in you case 0.64. This correlates to Metavir Stage F3 (range 0.59-0.72).
I've has Fibrosure done twice. In 2001, I has just had a liver biosy which showed F3-4. However my Fibrosure (we call it FibroTest) result was only 0.46 (F1-2).
In 2008 I has a Fibroscan which showed definite cirrhosis (F4). The FibroTest 3 months later came in at 0.54, or F2. That's why I don't believe it. cheers.
Tig said
Feb 26, 2015
Hi Bill,
The Fibroscan is a specialized ultrasound test that measures fibrosis essentially by measuring density. It utilizes a specialty probe and U/S unit which is different than the typical abdominal ultrasound. The Fibrosure measures blood markers and then an algorithm is used to approximate fibrosis. There are inaccuracies at both the lower and upper levels of fibrosis. There are many other reports on the web. It's a disputed subject for sure. This is just my opinion Bill and the findings in this report. You should trust your health care team, but you are your own best advocate and questions should always be allowed and considered by them. Best....
I changed the link due to closure of the previous article. (1.08.16)
-- Edited by Tig56 on Friday 8th of January 2016 09:31:43 PM
masbirdies said
Feb 26, 2015
I understand that one of these is an "ultrasound" type test and the other is a blood test. What are the disadvantages of the Fibrosure? My results were F3 Bridging Fibrosis with many septa. .64 is the number associated.
Hi Linda,
This is off-topic, but a diagnosis of cirrhosis based on MRI only is hazardous. Many patients with 'early' cirrhosis have very few changes. As the severity of cirrhosis progresses, there are many characteristic signs. These include: Enlargement of the liver, enlargement of the caudate lobe with relative shrinking of the R lobe, changes in some caudate lobe width ratios, enlargement of the gallbladder fossa, nodularity of the liver surface, presence of regenerative nodules, distortion of the hepatic veins etc etc. These features can be seen just as well on Ultrasound or CT.
The real value of MRI is the diagnosis of regenerative nodules, the feature of cirrhosis. Contrast is required and T1 Gradient Echo imaging shows these nodules to be hypointense, but isodense after contrast. It is also possible to see dysplastic nodules or even HCC.
Obviously, ascites and portal hypertension can also be shown. At late stages, the shrunken scarred liver is obvious.
I've had several MRI's and it really takes some imagination to see any regenerative nodules. I certainly wouldn't diagnose cirrhosis on the basis of my findings. Just saying.........
Can a diagnosis of cirrhosis be safely made with a MRI?
That's how I was originally diagnosed 3 years ago and then I did the Fibrosure in order to be eligible for treatment and it indicated F3-F4 (not sure what the number was). I am wondering if the Fibrosure can be so inaccurate, then is there any solid basis for my cirrhosis diagnosis. I never had a biopsy.
Hi Bill,
The Fibroscan measures liver stiffness by measuring the attenuation of an ultrasonic 'shear-wave'.
Fibrosure uses a formula based on biochemical parameters. One of these is the GGT level, which is known to fluctuate wildly. Many of us don't like it for this reason. The Fibrosure result is given as a number, in you case 0.64. This correlates to Metavir Stage F3 (range 0.59-0.72).
I've has Fibrosure done twice. In 2001, I has just had a liver biosy which showed F3-4. However my Fibrosure (we call it FibroTest) result was only 0.46 (F1-2).
In 2008 I has a Fibroscan which showed definite cirrhosis (F4). The FibroTest 3 months later came in at 0.54, or F2. That's why I don't believe it. cheers.
Hi Bill,
The Fibroscan is a specialized ultrasound test that measures fibrosis essentially by measuring density. It utilizes a specialty probe and U/S unit which is different than the typical abdominal ultrasound. The Fibrosure measures blood markers and then an algorithm is used to approximate fibrosis. There are inaccuracies at both the lower and upper levels of fibrosis. There are many other reports on the web. It's a disputed subject for sure. This is just my opinion Bill and the findings in this report. You should trust your health care team, but you are your own best advocate and questions should always be allowed and considered by them. Best....
http://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-staging/core-concept/all
I changed the link due to closure of the previous article. (1.08.16)
-- Edited by Tig56 on Friday 8th of January 2016 09:31:43 PM
I understand that one of these is an "ultrasound" type test and the other is a blood test. What are the disadvantages of the Fibrosure? My results were F3 Bridging Fibrosis with many septa. .64 is the number associated.