📩 13/06/2023 12:56
Prof. from the Department of Gastroenterology at Memorial Bahçelievler Hospital. Dr. A. Emre Yıldırım gave information about fatty liver and Fibroscan technology.
Conditions such as obesity, diabetes and high cholesterol can cause fatty liver. Since the incidence of these diseases has become a pandemic, the rate of development of fatty liver disease and related cirrhosis and liver cancer increases in parallel. Today, especially in developed countries, the most common cause of liver cirrhosis and liver transplantation is known as fatty liver disease. It is important to recognize this disease early, determine its severity, and take precautions and treat it. Fatty liver is seen in 4 out of every 1 people in Turkey. The damage in fatty liver, which was detected by biopsy in the past, can be easily detected with the device called Fibroscan, with the development of technology.
Prof. from the Department of Gastroenterology at Memorial Bahçelievler Hospital. Dr. A. Emre Yıldırım talked about Fibroscan and said, “Fibroskan uses vibration elastography technology to evaluate the scar tissue (fibrosis, that is, connective tissue) that occurs after liver damage due to various reasons. With this technology, the hardness and elasticity of the liver are measured. Its reliability in determining the level of liver fibrosis has been proven by many clinical studies and has been established in guidelines and has become a frequently preferred method as an alternative to an invasive, that is, cutting procedure applied to the body, such as liver biopsy. said. Yıldırım continued his explanations as follows:
“With Fibroscan, liver elastometry, that is, medical imaging that helps in determining the stiffness of organs or other structures is performed. In this technique, the Fibroscan device creates rapid vibrations without damaging the liver and measures the stiffness (fibrosis) of your liver based on the speed of these vibrations. It is based on the grading principle of liver fibrosis by evaluating the differences that occur as a result of the sound waves created by vibration using a method similar to ultrasonography, hitting the liver, changing depending on the hardness or softness of the liver, and returning them with a software program. With this method, it gives information about how much scar tissue is formed or whether cirrhosis has developed. Since this grading has close values with liver biopsy, it is a non-invasive method preferred over liver biopsy.”
Fibroscan is used in hepatitis and fatty liver problems
Emphasizing that the Fibroscan method is used in hepatitis and fatty liver problems, Yıldırım said, “Many liver diseases, especially viral hepatitis such as hepatitis B and C, fatty liver disease, alcoholic liver disease, metabolic liver diseases, can cause liver fibrosis. Fibroscan is a preferred method today to determine the presence or progression of these diseases and to manage treatment options correctly. Fibroscan is not recommended for cirrhotic patients with intense assists and pregnant women. Body structures such as excessive obesity and very narrow ribs can make it difficult to comply with the fibroscan device and prevent accurate results. In these cases, the correct result can be achieved by using body maneuvers to widen the ribs or using a larger scanner part. Fibroscan testing is not recommended in people with devices that may interact with magnetic fields, such as pacemakers or other medical implants, and in people with acute biliary tract infections.” made the statement.
A solution to the biopsy problem in fatty liver diseases
"Liver fat is usually diagnosed by other diagnostic methods such as ultrasonography or blood tests," said Prof. Dr. A. Emre Yıldırım said, “Liver lubrication can be in the form of simple lubrication without causing inflammation (an inflammatory condition), or it can reach a serious level and develop liver fibrosis, which can cause serious liver diseases such as cirrhosis and liver cancer in the later stages. Therefore, advanced diagnostic methods such as liver biopsy or fibroscan, which are conventional methods, can be used to determine the risks to liver health of patients with fatty liver. Since Fibroscan gives results close to liver biopsy, it can prevent unnecessary biopsy for diagnosis in many diseases, and can be used to monitor the effectiveness of treatment in many diseases. However, having Fibroscan does not always eliminate the need for biopsy.” used his statements.
Stating that people with fatty liver may develop fibrosis due to the accumulation of fatty cells that can increase stiffness, Prof. Dr. A. Emre Yıldırım, “Fibroscan can be used to determine liver fibrosis in people with fatty liver. In this way, more detailed information can be obtained about the level of fatty liver of the patient, whether it is progressing and what risks it carries in terms of liver health. This information can be helpful in monitoring the course of the disease and determining the appropriate treatment.” used the phrase.
A painless and comfortable method
Stating that there is a vibration sensation that does not usually cause discomfort during the procedure, Yıldırım said, “Patients do not have pain, ache or burning sensation. Since Fibroscan is not an invasive procedure like a liver biopsy, normal activities can be returned immediately after the procedure.” said.
Fatty liver can be determined within 5-10 minutes
Prof. from the Department of Gastroenterology at Memorial Bahçelievler Hospital. Dr. A. Emre Yıldırım continued his statements as follows:
“Because Fibroscan is a procedure that requires medical expertise, it is only performed by a gastroenterology specialist with authorized training.
The patient should not have fasted for at least 2 hours before the procedure and should not have consumed a liquid containing caffeine such as coffee. In addition, it may be necessary for the patient to take or stop taking the drugs by reviewing the drugs he was using before the procedure by his doctor.
The patient is asked to lie on his back on the bed where the procedure will be performed, with his right hand under his head, on the back of his neck. The clothes are removed so that the abdomen is exposed.
After applying some gel on the sensitive probe, which is the scanner part of the Fibroscan device, the place where it is thought to be a good measurement will be determined in the lower right part of the patient's thorax and contacted with the skin between the ribs. Measurements are taken from these regions by scanning the liver using sound waves and vibration technology. This process takes about 5-10 minutes.
At the end of the procedure, the FibroScan device produces a numerical result that measures the amount of fat, stiffness and elasticity of the liver. The results can be viewed on the screen displayed on the device or as a printout.”
It can also be used to measure spleen stiffness.
Referring to the fact that Fibroscan is mainly designed to evaluate liver stiffness, it has recently been used to measure spleen stiffness, Prof. Dr. A. Emre Yıldırım said, “Spleen elastography is a method performed with a fibroscan device and used to measure the stiffness of the spleen tissue and the degree of fibrosis. This method can also be used in the evaluation of portal hypertension, especially in conditions such as liver diseases. Portal hypertension, which may occur due to liver diseases, can cause an increase in the size of the spleen and the development of fibrosis in the spleen tissue with high pressure in the portal veins of the liver. Thus, splenic elastography with fibroscan can play an important role in the detection of portal hypertension and in the evaluation of liver diseases.” he ended his speech.