Non-invasive methods of assessing liver fibrosis, such as transient elastography
The goal
- Goal: identify ADVANCED FIBROSIS and PORTAL HYPERTENSION without a biopsy
- Fibrosis stage is the single strongest predictor of liver-related outcomes - the grade of inflammation is not
- Two families of test:
- Serum panels - simple (FIB-4, APRI, NAFLD fibrosis score) or proprietary (ELF, FibroTest)
- Imaging elastography - vibration-controlled transient elastography (FibroScan), 2D shear-wave elastography, MR elastography
- Two-step pathway is now standard: a cheap, sensitive rule-OUT test first (FIB-4), then elastography only in the indeterminate/high group
10 more sections, plus exam facts
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