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magnetic resonance elastography
Dec 20, 2011

Hello Dr. McGovern, What is you opinion concerning magnetic resonance elastography? My IDS/Hep Dr wants me to have a needle biopsy but I have been reading about this noninvasive procedure that the Mayo Clinic is doing. I had a liver biopsy about ten years ago and it really was a pain in the side. Thanks, Billy

Response from Dr. McGovern

Good question.

The main problem is that elastography is available in very few centers as opposed to Europe where it is widely available. I think it is a great test which gives very accurate information about the degree of scarring in the liver.

If you had a liver biopsy 10 years ago and never got treated, I would guess that your first liver biopsy didn't show much scarring. If you are very concerned about getting another liver biopsy, you might want to ask your doctor about whether he or she would support getting a non-invasive test such as Fibrosure or Fibrotest, which is a simple blood test.

Studies seem to suggest that these blood tests are good at telling you has little disease or who has a lot of disease. If you had very little disease to start and a blood test showed the same thing, this may give you and your doctor some piece of mind. If the two tests were extremely different, then you might want to get a liver biopsy as confirmation that your disease was progressing.

Another important factor that I weigh when trying to interpret the blood test is what my own suspicion of liver disease is based on things like alcohol intake. As you probably know, heavy alcohol use increases scarring of HCV disease at a much more rapid rate.

Hope this is helpful.



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