Patient education: Liver elastography (The Basics)

What is liver elastography? — 

This is an imaging test to check the stiffness of the liver. Imaging tests create pictures of the inside of the body. The liver is a big organ in the upper right side of the belly (figure 1).

If your doctor is concerned your liver is stiffer than normal, they might have you get a liver elastography test. Stiff areas of the liver are a sign of liver damage.

Your doctor might order this test to:

●Look for problems in the liver, like scarring ("fibrosis") or cirrhosis

●Decide how to treat liver disease

●See how treatment is working

●Predict complications from some liver problems

Liver elastography can be done in 2 ways:

●Ultrasound – This uses sound waves to creates pictures (figure 2).

●MRI – MRI stands for "magnetic resonance imaging." It uses a strong magnet to create pictures (figure 3).

How do I prepare for liver elastography? — 

The doctor or nurse will tell you if you need to do anything special to prepare. Before the procedure, your doctor will do an exam and ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

If you are having an MRI, tell the doctor about:

●Any metal in your body – This includes medical devices like pacemakers, artificial joints, ear implants, or IUDs (a type of birth control). It also includes any hardware like pins, screws, metal plates, or staples that might have been put in during surgery (for example, to fix a broken bone). The MRI scanner uses a big magnet to create images. If you have metal in your body, your doctor will talk to you about whether it is safe to have an MRI.

●Any other devices or materials on your body – These include things like insulin pumps, medicine patches, piercings, and dentures. You will also be asked if you have any tattoos or permanent makeup. These can affect the pictures from an MRI scan.

●If you get nervous in small spaces – Some MRI machines are narrow. If small spaces make you feel nervous or anxious, tell your doctor. You might be able to request a "wide-bore" scanner with more space inside. If needed, your doctor can also prescribe medicine to help you stay calm during the test. If you might not be able to lie still for the entire test, your doctor will talk to you about other options, such as sedation.

You might be asked to do these things for a period of time before the test:

●Not eat anything

●Not drink alcohol

●Not smoke

●Avoid strenuous exercise

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during liver elastography? — 

When it is time for the procedure, you might need to remove your clothes and put on a gown.

For an ultrasound:

●You will lie down. The person doing the ultrasound will put a small amount of gel on your abdomen.

●They will press a thick wand, called a "transducer," against your skin. They will move the transducer around on your skin. Images will appear on a computer screen so the doctor can see the organs and structures in your abdomen. In some cases, color images give information about where and how fast blood is flowing.

●This test does not usually hurt. But you might feel pressure when the transducer presses against your skin. You might need to change positions or hold your breath for a few seconds during the test.

●After the ultrasound, the staff will wipe the gel off your skin and you will get dressed.

For an MRI:

●You will remove any metal objects from your body. These include jewelry, glasses, dentures, and hearing aids.

●You will get earplugs or headphones to wear. This is because the MRI machine is very loud, and the sound can damage your ears if you don't have ear protection. Wearing earplugs or headphones will help make you more comfortable. You might also be able to listen to music if you want.

●If your doctor prescribed medicine to help you stay calm during the scan, you will take this before the scan.

●You will lie on the narrow table of the MRI machine. The table slides into the scanner. The staff will not be in the room with you, but they will be nearby and able to see you and talk to you.

●The staff will place some small devices on your abdomen. One will send vibrations to your liver. Others will send and receive radio waves.

●You will need to lie very still during the scan, so the images are clear. You might also be asked to do other things, like hold your breath for a few seconds. The machine does not touch you, and the test does not hurt.

●After the scan, you will get dressed.

Liver elastography usually takes 30 to 60 minutes.

What happens after liver elastography? — 

The doctor will review the test results. The results might help them learn more about any problems you are having. You might need to have other tests or procedures. Discuss all test results with your doctor. They can help you understand what the results mean.

If you got medicine to help you stay calm during the test, someone will need to take you home afterward.

What are the risks of liver elastography? — 

Your doctor will talk to you about all the possible risks, and answer your questions. These tests usually do not have any risks to your health. They do not expose you to radiation like an X-ray.

What else should I know? — 

Before you go home, make sure you know what problems to look out for and when you should call the doctor. Make sure you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Abdominal ultrasound (The Basics)
Patient education: MRI scan (The Basics)
Patient education: Cirrhosis (The Basics)
Patient education: Liver cancer (The Basics)
Patient education: Liver biopsy (The Basics)
Patient education: Metabolic dysfunction-associated steatotic liver disease (The Basics)
Patient education: Hepatitis B (The Basics)
Patient education: Hepatitis C (The Basics)

Patient education: Cirrhosis (Beyond the Basics)
Patient education: Liver biopsy (Beyond the Basics)
Patient education: Metabolic dysfunction-associated steatotic liver disease (Beyond the Basics)
Patient education: Hepatitis B (Beyond the Basics)
Patient education: Hepatitis C (Beyond the Basics)