An Outlook On Elastography For Evaluating Fatty Liver Diseases

Oct 7, 2022

What Are Fatty Liver (NASH/ASH) Diseases?

A fatty liver is when there is too much fat in the liver cells. This alone is not an illness, but a finding. The most common causes are obesity, alcohol, medication and/or diabetes. However, fatty liver can also be a symptom of other diseases, such as viral hepatitis or iron storage disease. It is difficult to distinguish obesity-related fatty liver from alcoholic fatty liver; In addition to physical examinations, questions must be asked about living and drinking habits, even if this question is often perceived as stigmatizing. Fatty liver is very common in the general population.

A simple fatty liver is unfavorable, but rarely leads to liver damage. However, if the fatty liver is inflamed (fatty liver or steatohepatitis), this is a serious finding. A distinction is made between alcohol-related ASH (alcoholic steatohepatitis) and NASH (non-alcoholic steatohepatitis) caused by other causes. Both types of fatty liver inflammation can scar the liver over the long term and cause cirrhosis.

Liver cirrhosis increases the risk of hepatocellular carcinoma (HCC). In non-alcoholic fatty liver inflammation, liver cancer can also occur before cirrhosis is present. Fatty liver inflammation (NASH) also increases the risk of cardiovascular disease.

Clinical Emphasis

Fatty liver disease is an extremely common clinical condition, and most endocrinologists prefer patients to go through non-invasive testing for staging and follow-up. This is where elastography is gaining increasing acceptance as a non-invasive method for the evaluation of the fatty liver stage (Steatosis) and Fibrosis stage of the liver.

What Is Elastography?

Elastography is a real-time ultrasound noninvasive procedure used to assess liver tissue elasticity and is a fast, simple, reproducible, and reliable method for liver steatosis/fibrosis evaluation. The diagnosis and management, choice of treatment needed, or any further screening for chronic liver diseases depends on the grade of liver steatosis/fibrosis.

Traditionally the standard procedure to diagnose and evaluate the stage of liver steatosis/fibrosis is through liver biopsy. However, this procedure has many paramount shortfalls as a medical screening test. Alongside being invasive, it has problems in areas like accuracy, safety, and accessibility and also carries a fair risk of morbidity and mortality, making the analysis of the entire liver based on this procedure not feasible or practical.

At GluCare we use elastography which grades hepatic steatosis/fibrosis in patients with fatty liver diseases and is a noninvasive tool for the surveillance and prognostication of complications related to fatty liver disease. The procedure was exclusively designed to combat most shortfalls traditional liver biopsy experienced.

Techniques Used For The Evaluation

Elastography as a tool for the evaluation of fatty liver disease relates to palpation. This is based on the premise that diseased organs feel relatively harder than the normal surrounding tissue. Elastography allows us to measure the amount of fat in the liver tissue and its Stiffness (or hardness) and convert them to numbers and stages of fatty liver diseases with and without fibrosis.

Under healthy conditions, the amount of fat and stiffness in the liver is very low. However, the inflammation resulting from fatty liver disease can cause the liver cells to die and be replaced by scar tissues. As this process (steatosis and fibrosis) continues, the scar tissues become progressively rigid, causing the stiffness in the tissue to increase further.

Based on the results and their evaluation, your endocrinologist can give you the most effective treatment and management plan that same visit.

At GluCare, we are the only speciality one-stop-shop facility for endocrinology and metabolic diseases in the United Arab Emirates. We cater to every aspect of a patient’s endocrine needs, including chronic liver diseases. At GluCare, we use elastography testing as a standard for our diabetic patients.Our model does not require you to have multiple visits or referrals. You will have your liver assessment done immediately before seeing your endocrinologist.

Our team consists of top-ranked endocrinologists who also use Continuous Metabolic Monitoring to deliver the highest quality endocrinology care towards sustainable disease management.

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