Fatty liver disease (FLD)/ Hepatic Steatosis | All You Need to Know!

Imaging Modalities

Imaging modalities are of utmost importance in liver diseases. Many liver diseases can be diagnosed by imaging and it can also outline some treatment choices. The most commonly performed imaging tests for the liver include:

• Ultrasound: Ultrasonography is the most commonly performed imaging modality for its availability and ease of use. It is also non-invasive and painless. Ultrasonography can give a general impression of the state of the liver and can detect whether there is a liver enlargement or advanced liver disease (cirrhosis). It can also detect the presence of gallbladder stones.
• MRI: Although not commonly used, magnetic resonance imaging can be useful in confirming the presence of fatty liver disease or excluding it. It can also detect liver stiffness, which is an important measure of liver fibrosis in advanced liver disease.
• CT scan: CT scan can be used to follow up on the progression of liver disease and detect other abnormalities and diseases that present like fatty liver disease.
• ERCP or MRCP: Both MRCP and ERCP are special imaging modalities of the biliary tree. They are not specific to fatty liver disease, but they can detect the presence of stones and other diseases in case of jaundice and may be used before your doctor confirms that fatty liver is the reason behind your jaundice.

Liver Biopsy

Although liver biopsy is not always done in cases of fatty liver disease, especially the alcoholic subtype, it remains the best diagnostic modality to confirm the diagnosis. A liver biopsy involves taking a small sample of the liver using a special needle. Your doctor will use local anesthesia to insert the needle. Afterward, the sample is sent to the lab to be examined under the microscope using special stains and chemical substances. A liver biopsy can also help exclude other diagnoses and make a prediction of the outcome and the stage of liver disease.

Ideally, all patients suspected of having fatty liver disease should undergo a liver biopsy, and when doctors decide not to do it, it is usually because either the diagnosis is very clear by other tests and symptoms or because there is an increased risk of complications of biopsy in a specific individual.