Fatty liver is commonly reported on ultrasound, but ultrasound alone does not show how advanced liver disease is. The amount of fat and the degree of fibrosis are different questions.
Assessment includes metabolic factors such as body weight, diabetes, blood pressure, lipids, sleep apnoea and alcohol exposure. Non-invasive fibrosis scores from blood tests and, when appropriate, elastography can help identify patients at higher risk of advanced fibrosis.
Management centres on sustainable weight control, physical activity and treatment of metabolic risk. If advanced fibrosis or cirrhosis is suspected, follow-up changes to include assessment for portal hypertension and liver cancer surveillance.
An ultrasound report of fatty liver is therefore the beginning of risk assessment, not the end.
Assessment includes metabolic factors such as body weight, diabetes, blood pressure, lipids, sleep apnoea and alcohol exposure. Non-invasive fibrosis scores from blood tests and, when appropriate, elastography can help identify patients at higher risk of advanced fibrosis.
Management centres on sustainable weight control, physical activity and treatment of metabolic risk. If advanced fibrosis or cirrhosis is suspected, follow-up changes to include assessment for portal hypertension and liver cancer surveillance.
An ultrasound report of fatty liver is therefore the beginning of risk assessment, not the end.
