Imaging Measures Internal Signs of ‘Silent’ Liver Disease

The liver plays multiple roles in everyday bodily function. It affects digestion, metabolism, blood clotting and hormone production, among other critical processes. Yet liver disease can be surprisingly stealthy. If you have the common but potentially serious condition known as a fatty liver, you might not show obvious signs. Your first clue that something’s wrong will probably turn up in your annual bloodwork.

If that happens, your doctor will likely recommend further screening, as bloodwork alone isn’t sufficient to make a diagnosis. While a biopsy can confirm fatty liver disease, doctors often recommend noninvasive imaging services instead.

One fast, convenient imaging technique measures scarring in the liver. It helps doctors diagnose fatty liver disease, determine its severity, make a treatment plan and monitor the effects of treatment.

When liver symptoms stay ‘silent’

The liver plays an important role in helping the body eliminate unhealthy substances and toxins. A poorly functioning liver can allow those substances to build up in the body, leading to classic signs of liver disease:

• Abdominal pain
• Dark-colored urine
• Diarrhea
• Fatigue
• Pale or light-colored bowel movements
• Nausea and vomiting
• Yellowing of the skin and eyes

However, people in the earlier stages of fatty liver disease usually don’t experience these classic symptoms. But even as their health appears normal on the outside, the disease can cause serious damage on the inside: liver scarring known as fibrosis, which can then develop into cirrhosis or liver cancer.

That’s important because fatty liver disease is so common—and not just among people who drink a lot of alcohol. In fact, study published in 2020 found that as of 2010, 2% of the American population has alcohol-related fatty liver disease, but 21 to 24.7% has nonalcoholic fatty liver disease (NAFLD), for which there is no known cause.

There are two types of NAFLD. One is far more serious than the other. The first type, known as simple fatty liver, typically doesn’t result in organ damage or complications. The second type, nonalcoholic steatohepatitis (NASH), involves potentially damaging inflammation.

Like alcohol-related liver disease, NASH causes fibrosis that can lead to cirrhosis or liver cancer. Still, NASH tends to stay “silent.” Someone with cirrhosis caused by NASH might experience only mild symptoms, like fatigue or abdominal pain in the upper right side of the body, if they experience any symptoms at all.

Who’s at risk of fatty liver disease?

We don’t know exactly what causes NAFLD (including its more dangerous subset, NASH). But we do know the risk factors for developing it:

• Being middle-aged or older
• Being obese
• Being of Hispanic background
• Having high blood pressure
• Having high cholesterol or triglycerides
• Having metabolic syndrome
• Having prediabetes or diabetes
• Taking certain medications, such as corticosteroids

You can’t control some factors, like age, culture and ethnicity, but you can mitigate much of your risk of liver disease through diet, exercise and other lifestyle changes.

Detecting and managing fatty liver disease

If you detect fatty liver disease in time, it’s possible to halt the disease process. The damage to the liver can’t be undone, but with medical intervention and proper lifestyle changes, you can prevent further damage and manage the disease.

On the other hand, liver disease that goes undetected and untreated can lead to liver failure. At some point, liver transplantation may become the only lifesaving treatment option.

Doctors use FibroScan imaging technology to detect, diagnose and monitor various liver conditions, including fatty liver disease, hepatitis and liver cancer. FibroScan works much like ultrasound, producing an image of the liver by measuring the speed of sound waves that pass through it.

Unlike other imaging technologies, however, FibroScan specifically detects and assesses liver stiffness, which indicates scarring from disease. The results can help guide the best course of treatment, whether that’s surgery or chemotherapy, or medication and lifestyle modifications.

What to expect with FibroScan

If your doctor orders a FibroScan to diagnose or monitor fatty liver disease, don’t eat or drink for three hours leading up to your appointment.

The scan itself usually takes just 5 to 15 minutes. It’s also completely painless and safe. You simply lie on your back while your technologist passes a handheld wand over the skin on the right side of your abdomen. A radiologist will review the images and report the results to your doctor.

Numerous American Health Imaging centers offer same-day appointments and a lower-cost scan than are offered at the hospital. AMI’s radiologists will provide a full report to the referring doctor within 24 hours. You can learn more about FibroScan imaging.