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Scans and imaging tests
Imaging tests allow doctors to take detailed images of your internal organs and tissue, and assess the size, shape and surface appearance of your liver. They can also test the stiffness of the liver – healthy liver tissue is soft, so stiffness indicates that damage has occurred.
Ultrasound
An ultrasound scan is a very common test used to look at your liver, gallbladder or other parts of your tummy (abdomen). Find out more here.
There is a technique similar to ultrasound, known as elastography, or transient elastography, which doctors can use to measure the stiffness of the liver. Healthy liver tissue is soft, so if stiffness is detected, fibrosis (scar tissue) may be present. The most common name for this kind of test is FibroScan. Tests such as FibroScan can’t diagnose specific liver diseases but they can give doctors an idea of how badly the liver is damaged.
Sheer wave elastography (SWE)
This is a more advanced version of the technique described above, which uses a focused ultrasound wave to give radiologists a clearer picture of how ‘elastic’ (soft) the liver is. The waves travel slowly through healthy liver tissue and faster through scarred areas.
Acoustic radiation force impulse imaging (ARFI)
This is another imaging technique. It works by ‘pushing’ the tissues in the body to assess their stiffness – softer, healthy tissue is more easily pushed than stiffer tissue, which may indicate fibrosis.
CT scan (computed tomography scan)
A CT scan is a special type of X-ray. It can take detailed pictures of the inside of your body. Find out more here
MRI (magnetic resonance imaging)
An MRI is a type of imaging test that makes detailed pictures of the inside of your body. It is used to diagnose and check on lots of different medical conditions, including many liver and gallbladder conditions. Find out more here
MRE (magnetic resonance elastography)
This is an MRI-based advanced technology that uses imaging with soundwaves to create a detailed picture of the body, and is particularly good at showing hardening and stiffness of liver tissue. A small pad is placed on the skin, through which low-frequency vibrations are passed into the liver. A computer measures the speed at which tissues in the liver vibrate – the quicker the vibrations, the more fibrosis is present. MRE can detect fibrosis at an earlier stage than other tests, and give an indication of how severe the fibrosis is.
MRCP (magnetic resonance cholangiopancreatography)
MRCP is a test using specialised magnetic resonance imaging (MRI, above) to provide doctors with a picture of your biliary (bile-carrying) and pancreatic ducts. In this scan, the fluid in your biliary ducts appears brighter while the surrounding organs and tissues will appear darker.
The procedure can be used to find out whether gallstones are lodged in any of the ducts surrounding your gallbladder. The scan is painless and takes about ten minutes unless combined with a normal MRI scan (an extra 20 to 30 minutes) and is normally performed as an outpatient appointment.
X-rays
An X-ray is a common and painless examination in which invisible radioactive waves are passed through your body to record an image of your internal organs. A special X-ray that studies the veins and arteries that supply blood to the liver is known as hepatic angiography. This X-ray may be needed if your diagnosis is still doubtful after a CT and MRI scan. The procedure uses a catheter (a thin, flexible tube) that is placed into blood vessel though a small cut in your groin. A dye, referred to as a ‘contrast dye’ or ‘contrast medium’, is then injected through the catheter to light up the blood vessels to make them easier to see. A hepatic angiogram is usually done under local anaesthetic and you are also likely to be given sedation. Because of this, you may be asked to stay in hospital overnight (the minimum stay is six hours). The test is usually uncomfortable, rather than painful. You should be able to drive the next day.
For further information about these tests talk to your specialist or your medical team.