206807 tn?1331936184

Can Cirrhosis be Diagnosed without Biopsy?

Can Cirrhosis be Diagnosed without Biopsy?
Hello all, it’s been a few years and I don’t see many that would remember me. I was successfully treated back in the “Medieval Days of Torture.”
I know a lot has changed since then. I have a family member that says he was told he had cirrhosis but there was no biopsy performed. He did say they did perform Sonogram.   I explained to my wife, a sonogram will show fat and fibrosis but a Biopsy would be needed to confirm the severity (Fibrosis or Cirrhosis. He also said he may have HBC or HCV. This also doesn’t make sense. Why would a Gastro? Even draw such conclusions without running tests? I think he is just confused because a lot of DRS don’t take time to explain and forgets the average person initially goes into a state of shock and only hears the negative. So back to my question. Is there any way to Diagnose cirrhosis without performing a Biopsy. Please attach links to websites if you don’t mind. Thanks,  R Glass.
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Avatar universal
Cirrhosis can be diagnosed with noninvasive cross-sectional imaging. Morphologic changes include relative hypertrophy of hepatic caudate and left lateral lobes, contour nodularity/lobularity, and widening of intrahepatic fissures.
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CHIN_C Thank you.
683231 tn?1467323017


People with early-stage cirrhosis of the liver usually don't have symptoms. Often, cirrhosis is first detected through a routine blood test or checkup. To help confirm a diagnosis, a combination of laboratory and imaging tests is usually done.


Your doctor may order one or more tests that may suggest a problem with your liver, including:

Laboratory tests. Your doctor may order blood tests to check for signs of liver malfunction, such as excess bilirubin, as well as for certain enzymes that may indicate liver damage. To assess kidney function, your blood is checked for creatinine. You'll be screened for the hepatitis viruses. Your international normalized ratio (INR) is also checked for your blood's ability to clot.

Based on the blood test results, your doctor may be able to diagnose the underlying cause of cirrhosis. He or she can also use blood tests to help identify how serious your cirrhosis is.

Imaging tests. Magnetic resonance elastography (MRE) may be recommended. This noninvasive advanced imaging test detects hardening or stiffening of the liver. Other imaging tests, such as MRI, CT and ultrasound, may also be done.
Biopsy. A tissue sample (biopsy) is not necessarily needed for diagnosis. However, your doctor may use it to identify the severity, extent and cause of liver damage.
If you have cirrhosis, your doctor is likely to recommend regular diagnostic tests to monitor for signs of disease progression or complications, especially esophageal varices and liver cancer. Noninvasive tests are becoming more widely available for monitoring.”


Helpful - 0

flyinlynn  I remember you, thank you for your response and it pleases me to hear you defeated HCV.
Thanks I remember you too happy to hear your still kick in’

683231 tn?1467323017
The test performed was likely a fibroscan. It is similar to an ultrasound but the devise produces a sort of thump that can estimate liver stiffness. The Fibroscan report will have a score that can be converted to an “F” score (fibrosis score) The result also includes an estimate of inflamation.

If it was only an ultrasound this can show changes consistent  with cirrhosis like a coarsened echotexture. So that along with blood testing like having a low platelet count and other results consistent with cirrhosis along with symptoms of cirrhosis combined with a condition that could lead to cirrhosis can be used together to make a determination of cirrhosis even without having an invasive liver biopsy.

I treated 3 times in the past with the old interferon treatments but was a non responder. I underwent 4 liver biopsies once every five years after I was diagnosed with hep c. After what was likely 30 years of Hep c infection I was diagnosed with cirrhosis in my 4th biopsy back in January 2008.
Helpful - 0
Fibroscan information

There is also a blood test called a fibrosure that can also diagnose liver cirrhosis

A gastroenterologist should be able to properly diagnosis liver disease and cirrhosis.

Not sure why he would be told he may have HBV or HCV I guess if he tested positive for hep c antibodies he would need to have the HCV RNA by PCR test that looks for the actual virus in the blood and gives a viral load number.

I’ve heard that now often if there is a positive hep c antibody test the lab automatically will perform the HCV RNA test on the remaining blood sample to check for current active infection do a second test would not need to be performed and the patient could be advised from just this one test if they are currently infected with hep c.

I’m less familiar with HBV testing.
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