Liver Ultrasound & Elastography
Assessing the health of your liver by measuring fat content (steatosis) and stiffness (fibrosis). This is the key screen for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).
Key facts at a glance
Why liver health is central to longevity.
Silent Epidemic
An estimated 30% of adults worldwide have Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), often without symptoms.
~30%
Reversibility
Early-stage fatty liver is highly reversible with diet, exercise, and weight loss before scarring (fibrosis) sets in.
High
Accuracy
Elastography is excellent at ruling out advanced fibrosis and cirrhosis without the need for a painful biopsy.
>90%
Invasiveness
The procedure is external, quick, and radiation-free.
None
Who this is for
- Individuals with visceral belly fat, insulin resistance, or type 2 diabetes.
- Those with elevated liver enzymes (ALT/AST) on blood tests.
- People who consume alcohol regularly and want to assess damage.
What it measures
- Steatosis (CAP Score): The amount of fat stored in liver cells. Higher numbers = more fat.
- Fibrosis (Stiffness): How "stiff" the liver is. Stiffness correlates with scarring (fibrosis) or cirrhosis.
The Technology
- Standard Ultrasound: Good for seeing liver shape and masses, but poor at quantifying fat or mild scarring.
- Elastography (e.g., FibroScan): Sends a mechanical pulse (shear wave) through the liver. The speed of the wave tells us how stiff the tissue is—faster waves mean stiffer (scarred) tissue.
Understanding Results
- Normal: Low fat, low stiffness.
- Simple Steatosis: High fat, normal stiffness. Often completely reversible with weight loss and alcohol reduction.
- NASH / MASH: Inflammation is present, leading to cell damage.
- Fibrosis (F1-F4): Scar tissue has formed. F4 represents cirrhosis (permanent damage).
Why detect it early?
The liver is incredibly resilient and can regenerate, but only up to a point. Once advanced scarring (cirrhosis) occurs, the damage is often permanent and increases the risk of liver cancer. Detecting fatty liver early provides a "golden window" to intervene with lifestyle changes when they are most effective.
References
Guidelines and key studies.
- The diagnosis and management of nonalcoholic fatty liver disease — Hepatology (2018)
- Younossi ZM, et al.. Global Epidemiology of Nonalcoholic Fatty Liver Disease — Hepatology (2016)
- Castera L.. Noninvasive methods to assess liver disease in patients with hepatitis B or C — Gastroenterology (2012)View source — Review of elastography vs biopsy
Content is educational and not medical advice. For personal recommendations, consult your clinician.