Assess the degree of cirrhosis should liver biopsy or elastography

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Trinh Thi Phuong Nga - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital
Cirrhosis is the result of chronic liver damage. Liver fibrosis, if it goes on for a long time, will turn into cirrhosis, or more seriously, liver cancer. Currently, there are 2 common methods to check the degree of cirrhosis, namely liver biopsy and elastography of the liver parenchyma.

1. Learn about liver biopsies and elastography

Liver biopsy and elastography of the liver parenchyma are both methods used to assess the extent of cirrhosis.
1.1 Liver biopsy Liver biopsy is a procedure that uses specialized needles to take liver parenchymal cells for testing, through the guidance of ultrasound to diagnose histopathology. This technique is used to diagnose liver diseases such as liver cancer, hepatitis B, hepatitis A, and decompensated cirrhosis. Indicated for subjects who are in a number of cases:
There are tumor lesions in the liver, especially those suspected of being cancerous; Confirm the diagnosis of fatty liver or not, determine the degree of fatty liver if present; Provides detailed information about the severity of certain types of liver disease, such as chronic hepatitis (caused by hepatitis B or C viruses), alcoholic cirrhosis, or certain metabolic diseases... Case the patient has liver disease but the cause is unknown, or when the test detects there is an abnormality affecting the liver function; Assess tumor status found by ultrasound, computed tomography or magnetic resonance; Patients after liver transplantation need to be monitored. In addition, liver biopsy may be useful in certain situations such as: people with rare metabolic diseases with unexplained fever, people taking methotrexate, and a few other rare disorders. . For this method, there are also some contraindications that patients should note as follows:
People with blood clotting disorders (platelets < 50G/l; prothrombin rate < 50%); Cannot proceed without the consent of the patient and the patient's family; People with other malignancies of the liver are at high risk of bleeding; People with damaged blood vessels, signs of hemangioma suspected; Right lung infection or pleural effusion; Abdominal effusion.

1.2 Elastic ultrasound This is an ultrasound technique used to evaluate the stiffness of tissues, based on the degree of elasticity when the tissue is subjected to mechanical force.
Elastography of liver tissue is a non-invasive diagnostic method, but brings very high accuracy. Helps to overcome the shortcomings of biopsies in the process of determining liver fibrosis. This technique is often applied in the following cases:
Need to evaluate localized or diffuse lesions in the liver parenchyma; Assess the degree of cirrhosis. Thyroid tissue elastography: Diagnosis of thyroid nodules; Elastography of breast tissue: Diagnosis of breast tumor, breast cancer; Subjects are at risk of cirrhosis, liver cancer due to hepatitis B and C viruses, fatty liver caused by drinking a lot of alcohol or some metabolic diseases affecting the liver. In addition, there are some other common indications such as: Elastography of spleen, pancreas, kidney & prostate tissue.

2. Pros and cons of liver biopsy and elastography of liver tissue

Liver biopsy and elastography of liver tissue are both methods to support the diagnosis and treatment of liver diseases. However, both these methods have their own advantages and disadvantages, specifically as follows:
2.1 Pros and cons of liver biopsy Advantages:
Obtaining diseased tissue to help confirm diagnosis through surgery sick. Disadvantages:
As an invasive procedure, there is a risk of bleeding, infection.... The anesthetic and anesthetic used in this method can cause allergies. 2.2 Advantages and disadvantages of elastography of liver tissue Advantages:
Improve the specificity of diagnosis, narrow the indications for biopsy, reduce unnecessary biopsies; not miss the injury; The implementation process is simple, does not depend too much on the performer. Non-invasive, painless. Disadvantages:
Difficult to measure in people with narrow intercostal space, difficult to cooperate (cry babies, people with difficulty breathing,...)

Assess the degree of cirrhosis should liver biopsy or elastography is the question of many people. However, to get an exact answer depends on many issues, which should be consulted by a specialist. Because, only the doctor can orient the most suitable solution for the patient. At the same time, there is another factor that the patient needs to pay attention to, which is the skill and experience of the operator. Requires a high level of expertise and experience in the implementation of these methods. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment: 6 ultrasound rooms, 4 DR X-ray rooms (1 full-axis machine, 1 light machine, 1 general machine and 1 mammography machine) , 2 DR portable X-ray machines, 2 multi-row CT scanner rooms (1 128 rows and 1 16 arrays), 2 Magnetic resonance imaging rooms (1 3 Tesla and 1 1.5 Tesla), 1 room for 2 levels of interventional angiography and 1 room to measure bone mineral density.... Vinmec is also the place to gather a team of experienced doctors and nurses who will greatly assist in diagnosis and detection. early signs of abnormality in the patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.

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