Liver Biopsy (cont.)
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Alternatives to Liver Biopsy
In some instances, abdominal imaging studies can help make a diagnosis. As an example, blood tests might suggest that a patient is suffering from iron overload related to hereditary hemochromatosis. Specially-tailored MRI scans can help determine whether or not iron overload is truly present without the need for a liver biopsy.
Increasingly, non-invasive approaches are being used to assess the severity of chronic hepatitis C. Commercially available blood tests like Hepascore® and FibroSURE® assess blood levels of hyaluronic acid and other chemicals to help estimate the degree of liver inflammation and fibrosis (i.e. scarring) in patients with chronic hepatitis C.
Fibroelastography utilizes a specially-designed ultrasound unit to non-invasively assess the degree of liver fibrosis is patients with chronic hepatitis C. It remains to be determined whether fibroelastography will provide as accurate an assessment of liver fibrosis in other disease states (for example, chronic hepatitis B or alcoholic liver disease) as in chronic hepatitis C. Fibroelastography is undergoing testing in the United States and is not widely available at this time.
David C. Wolf, M.D., FACP, FACG, AGAF
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