I am 37 years old a hep B carrier for 14 years.
My blood test of liver function is normal. ALT is normal (I made a mistake of not testing them between 2007 and 2012, otherwise, yearly testing are normal). Creatinine and Bilirubin are normal. I have no any symptoms up to now.
Below please find my most recent ultrasound. My questions is:
1. what does the report in general mean?
2. Can stage 1 and 2, 3 been seen in ultrasound as coarse texture, or only stage 4?
3. The report says echopattern is normal but echo texture is coarse, why? (I think echo pattern is equivalent to echo texture)
4. What does “no focal abnomality” mean?
5. What’s the next step I should do (biopsy?) Should I have my IRN and al Serum albumin done:
Ultrasound of abdomen:
the gallabladder is normally distended, there are not gallstones present, no wall thickening and no bile duct dilatation.
the liver isnormal in size and echopattern. The spleen, pancreas and both kidneys are normal with no solid mass, large cyst, significant hydronephrosis or renal calculus.
the aorta is a normal calibre and there is no retroperitoneal adenopathy
Normal abdominal ultrasound. The hepatic echo texture is coarse which might reflect some hepatocellular disease; there is no focal abnomality present.
“1. what does the report in general mean?”
In my unprofessional opinion you’re doing good, you should talk with your doctor about any concerns you have.
“2. Can stage 1 and 2, 3 been seen in ultrasound as coarse texture, or only stage 4?”
Routine clinical ultrasound is a not a sensitive predictor of early fibrosis, it is the most useful for monitoring the development of hepatocellular carcinoma (HCC or liver cancer) or fibrosis F3 and cirrhosis. You should be scanned annually for the development of HCC using ultra sound, CT scan or MRI.
“3. The report says echopattern is normal but echo texture is coarse, why? (I think echo pattern is equivalent to echo texture)”
The echopattern is of normal findings for persons with HBV. Echotexture is coarse because you have HBV.
“4. What does “no focal abnomality” mean?”
No evidence of the development of HCC was found.
“5. What’s the next step I should do (biopsy?) Should I have my IRN and al Serum albumin done:”
Blood labs should be ran every six months to monitor for liver damage. Your ALT/SGPT turn normal so biopsy is unnecessary.
Most chronic hepatitis B carriers do not develop complications, approximately 15 to 40% develop complications that include the development of liver fibrosis and eventually cirrhosis, with a predisposition to hepatocellular carcinoma (HCC or liver cancer).
I only dream to be able to at least raise my 5 and 2-years-old up until they can graduate from high school (so I hope I can live up at least 15 years from now on). My family doctor seems to know little about the report. Before seeing my specialist, this report is such a torture to me :'(
Here is my follow-up questions if you or someone else can help:
1) As you suggested, if I do not take biopsy, how could I know if I have fibrosis or what stage I am in?
2) "The echopattern is of normal findings for persons with HBV. Echotexture is coarse because you have HBV. "
Do you mean it is possible that I have only HBV but not fibrosis. Do you have any idea of how likely that can be?
3) what's the difference between echopattern and echotexture? (Is the later a part of the former?)
Hi I understand you are confused, as Randy said the pattern is good there are no nodules but the texture is coarse which indicates damage.
In other words your liver is not smooth like it should be (echo texture) but there are no lumps (echopattern). You really would need a biopsy to find out the specific level of damage to your liver.
There are different levels of scarring and fibrosis. That is where the biopsy comes in. It is the gold standard for determining where you are on the scale from Fibrosis one to Fibrosis 4 (Cirrhosis)
You don't go from no fibrosis to cirrhosis, it is progressive.
Here is another site if you are still confused. I have to say you have been given really good advice here and from the other forums as well.
i just have a ultrasound report with cirrhosis on my liver, but all of my blood test was fine but the alt and ggt are a little bit high, my doctor sent me to gastroenterology doctor, and he said " u are totally fine and u dont have cirrhosis and i am so confused now, i just had a 3 year old kid and a month old baby...... i am so scary now..
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