Rapid diagnosis of latent cirrhosis of the liver in elderly patients

News 04/13/2020

Fibroelastometry is a highly sensitive and specific method. It has a high diagnostic significance.

Indications for use:

• confirmation of the diagnosis (chronic hepatitis, cirrhosis of the liver, non-viral chronic inflammatory liver diseases) 
• to assess the stage of liver fibrosis, control the effectiveness of treatment, etc.

With its help, the doctor can identify chronic liver diseases when the patient has no clinical manifestations and changes in laboratory parameters. This allows you to avoid performing a puncture liver biopsy in the presence of clinical contraindications to its implementation, which is especially important for elderly patients.

Regardless of the root cause, the development and progression of all chronic liver diseases are based on the processes of fibrogenesis, which eventually lead to cirrhosis. Determining the stage of fibrosis is crucial for the diagnosis, treatment strategy, and prognosis of any chronic liver disease. 

It is known that with age in the body of an elderly person there is a decrease in reserve and adaptive capabilities. In other words, there is a gradual violation of the functions of the organs and changes in their structure. However, unlike other internal organs, the aging process in the liver is the slowest. These include such phenomena as atrophy of the liver tissue and a decrease in the number of hepatocytes, a decrease in hepatic blood flow and a reduction in lymphatic capillaries, a decrease in liver mass.

In general, these phenomena should be designated as involutive changes, while such processes do not affect the elasticity of the liver, the measurement of which is the basis of fibroelastometry: a direct correspondence of the mechanical properties of the liver tissue (its elasticity) with the degree of severity of fibrosis.

Thus, specialists of the Department of Hepatology of the Loginov Moscow State Medical Center conducted a study to assess the role of age-related liver involution in changing its elasticity. It allowed us to conclude that age-related changes in the liver in the absence of chronic diffuse diseases in elderly patients do not significantly affect its elasticity.

The obtained data allow us to recommend liver fibroelastometry in patients of the older age group according to the same criteriaas for younger patients.

According to experts, the highest efficiency of fibroelastometry is proven for the determination of the fourth stage of fibrosis, i.e. cirrhosis of the liver, while the accuracy of the method is up to 92% with a sensitivity of 100%. This allows the doctor to recommend fibroelastometry as an express method to detect hidden forms of cirrhosis of the liver.

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