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Elastography (FibroScan): Everything You Need to Know (Explained)

Dr Rohit Bhaskar
Dr Rohit Bhaskar
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A FibroScan is usually ordered for patients with medical conditions that can affect liver health, such as hepatitis B, hepatitis C, type 2 diabetes, and obesity. The test can also be used to monitor liver health in patients with a history of alcohol abuse and a family history of liver disease.

A FibroScan can reveal fatty changes to the liver (steatosis) and scarring. There was a time when the liver could only be examined through invasive techniques. FibroScan has allowed doctors to learn more about the liver without resorting to invasive techniques, which is very efficient for purposes of monitoring.

There are two types of liver elastography (FibroScan) tests:

Ultrasound elastography, also known as Fibroscan, the brand name of the ultrasound device. The test uses sound waves to measure the stiffness of liver tissue. Stiffness is a sign of fibrosis.

MRE (magnetic resonance elastography), a test that combines ultrasound technology with magnetic resonance imaging (MRI). MRI is a procedure that uses powerful magnets and radio waves to create images of organs and structures inside the body. In an MRE test, a computer program creates a visual map that shows liver stiffness.

What Does Your FibroScan Result Mean?

Your FibroScan result will include measurements of the level of steatosis and scarring in your liver. The measurement of fatty change in your liver is the CAP score, while the measurement of scarring is the fibrosis score.

Fatty Liver/Steatosis

Lifestyle factors can influence the progression of non-alcoholic fatty liver disease. Inactivity and obesity are two of the biggest contributors to liver disease that is not due to heavy alcohol use.

The CAP score is measured in decibels per meter (dB/m) and ranges from 100-400.

A CAP score that falls anywhere between 238 to 260 dB/m represents 11-33% fatty change in the liver.

A CAP score that falls anywhere between 260 to 290 dB/m represents 34-66% fatty change in the liver.

A CAP score that is 290 dB/m or higher represents over 67% fatty change in the liver.

A healthy liver has a CAP score of 5% or lower. A mild fatty liver is over 5% but less than 33%. Over 34% but less than 66% is moderate, while over 66% is severe. Higher fat content is a risk factor for disease progression.


The two biggest risk factors for liver scarring are alcohol abuse and diseases like hepatitis. The fibrosis score measures the stiffness of the liver, which is indicative of scarring.

A fibrosis score of F0 to F1 ( 2 to 7 kPa) means there is little or no scarring on the liver.

A fibrosis score of F2 (7.5 to 10 kPa) indicates moderate scarring that has spread outside the liver.

A fibrosis score of F3 (10 to 14 kPa) indicates severe scarring which has spread and disrupts normal blood flow.

A fibrosis score of F4 ( 14 kPa or higher) means late-stage scarring or cirrhosis, where the scarring is permanent and the damage is irreversible.

Fibrosis scores allow doctors to plan treatment. Liver scarring is a serious condition and can lead to life-threatening complications if not addressed.

Reference: PMID: 23483859

Suggested Reading 

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