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chronic hep b carrier ultrasound concers
Hello, I'm almost 44you, I was diagnosed with chronic hep b, back in 1994. It seems was from birth.I'm originally from Italy ( Endemic area), also both of my parents back in 1994 tested positive for hbv, but cured.I was in the hospital for one week,in 1994 for check up. No biopsy was performed then,band I was told I was an healthy carrier. Then I came to Us in 1996. I stopped checking my liver,until I went to see an hepatologist in 2004. He performed liver biopsy, and diagnos was : grade 1 portal inflammation,with grade 1 minimal portal fibrosis. The doctor told me I had a good prognosis, and not to worry about for the next 10 years or so. I stopped checking my liver until 2015 or 2016. Then went to see a different gastroenterologist,which I still see now. In our first meeting, he told me,since I have no symptoms, most likely I was fine. In fact, we did liver ultrasound, and blood test, and told me everything looked fine, and no need to start treatment. We do the same tests every 6 months. Since May of 2016, hbv DNA viral load went up, and started treatment, viread 300mg, daily tablets. The last blood test and ultrasound, was in December 2016. Meeting the gastroenterologist, he looked at the blood test,and told me, the virus was almost totally gone. Which meant, the treatment is working.I asked him if we could have stopped the treatment,and he said no. I asked him about the ultrasound,and he told me everything was good. After a month or so, the gastroenterologist called me telling me, he wanted to get an mri done, because something didn't look fine in the ultrasound. I asked him, what I thought was wrong,and he told me he's pretty sure everything is ok,but the nodular looked a little strange. This was over the phone, I couldn't understand much, but I got the mri yesterday. What the order to schedule the mri says is: " Abnormal findings on ultrasound images", ( Course echotexture of the liver with small hyperchic focus seen on ultrasound). What this could possibly mean?. I'm very scared. I also researched some of this on the internet, could it mean is an early cirrhosis?. Please help me understand,thank you.
Hbsag quantitative is different test. What the doctor was telling is that the hbv DNA virus is almost gone because you are on medicine and within 6 months you will be undetectable. Now hbsag is different story and losing hbsag is what will cure you. Hbsag quantitative now is available in USA as a blood test.
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Hbsag quantitive is available at Quest laboratory in USA except New York State.
Sorry it must be the typo I meant to say hbsag quantitative and not "unsafe"
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Hello Mike,
Yes as i said to you before,i don't know how to read it from the blood test, but my GI told me it has almost cleared completely.Thank again.Talk to you soon.
Yes as i said to you before,i don't know how to read it from the blood test, but my GI told me it has almost cleared completely.Thank again.Talk to you soon.
I couldn't help but answer after reading your comments. Since 2011 and every ultrasound it reads coarse heterogeneous echotexture of liver. My doctor is one of the best in hbv treatment and she always tell me not to worry and it is normal. She never order AFP and she say will be fine. She did fibroscan and it was 5.5 Kpa. Is your alt/ast normal? How about unsafe quantitative? The test is available now in us. If all your tests are normal including fibroscan then I wouldn't worry.
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Hello,
Thanks for your reply. The ALT/AST are normal, within normal range after starting treatment almost a year ago'(Viread 300mg,daily). I don't know what you mean about unsafe quantitative. I don't know how to interpret this, but the doctor told after the last blood test, that the virus is almost gone, and the treatment is working. He ordered another test called "Fibrospect 2", and not "Fibroscan", which i read about it, seems to be a blood test to differentiate the severity of fibrosis. Please let me know, what you think.Thanks for your reply.
Thanks for your reply. The ALT/AST are normal, within normal range after starting treatment almost a year ago'(Viread 300mg,daily). I don't know what you mean about unsafe quantitative. I don't know how to interpret this, but the doctor told after the last blood test, that the virus is almost gone, and the treatment is working. He ordered another test called "Fibrospect 2", and not "Fibroscan", which i read about it, seems to be a blood test to differentiate the severity of fibrosis. Please let me know, what you think.Thanks for your reply.
I've been in your shoes and know how scary it is. I'm a 43 year old female who has HBV presumably from birth as well. I have monitored my liver very regularly, and so far show my liver to be good and an "inactive carrier". Two years ago I had a routine ultrasound and this time they found a nodule for the first time (that later was told was there all along from past CT scans). A few months after I had a CT scan, which said the nodule was a atypical hemangioma. I now have ultrasound and MRI alternating every 6 months. Almost a year ago my MRI showed 2 more small nodules, presumably more hemangioma. My liver doctor said these nodules are usually seen on scans but most overlook because they are so small and most often benign.
As for the course echotexure, for most it means a fatty liver, that can be helped by diet, more activity, and losing weight if needed. I would rely on what the MRI says over the ultrasound, from what my doctor tells me.
Best of luck. I know it's hard to not worry, but remember this too shall pass. I freaked myself out so much two years ago when I thought that nodule came out of the blue, and wish now I wouldn't have worried so much.
As for the course echotexure, for most it means a fatty liver, that can be helped by diet, more activity, and losing weight if needed. I would rely on what the MRI says over the ultrasound, from what my doctor tells me.
Best of luck. I know it's hard to not worry, but remember this too shall pass. I freaked myself out so much two years ago when I thought that nodule came out of the blue, and wish now I wouldn't have worried so much.
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Hello,
Yes in fact, the doctor called me with the results of the MRI, and turned out being a cyst.We need to repeat the test (MRI) in 3 months. I was looking on my last US, done in December 2016. It says on the US "Coarse echotexture with consistent fatty infiltration". But when i asked the doctor about cirrhosis, he said that from the MRI, they (I think radiology) think might be an early cirrhosis.He ordered another test called "Fibrospect 2". What you think about this? Thanks for your reply.
Yes in fact, the doctor called me with the results of the MRI, and turned out being a cyst.We need to repeat the test (MRI) in 3 months. I was looking on my last US, done in December 2016. It says on the US "Coarse echotexture with consistent fatty infiltration". But when i asked the doctor about cirrhosis, he said that from the MRI, they (I think radiology) think might be an early cirrhosis.He ordered another test called "Fibrospect 2". What you think about this? Thanks for your reply.
mri done just to rule out hcc.
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Hello,
Thanks for your reply.Yes the doctor called with the results of the MRI. It is a cyst,but we need to do the MRI, in 3 months again. Just talking to my doctor, i mentioned about cirrhosis, he said from the MRI (Radiology) think,might be a early cirrhosis.Anyway, he told me to diagnose cirrhosis we need to do another test, called "Fibrospect 2",not "Fibroscan". What you think?Thanks for your reply.
Thanks for your reply.Yes the doctor called with the results of the MRI. It is a cyst,but we need to do the MRI, in 3 months again. Just talking to my doctor, i mentioned about cirrhosis, he said from the MRI (Radiology) think,might be a early cirrhosis.Anyway, he told me to diagnose cirrhosis we need to do another test, called "Fibrospect 2",not "Fibroscan". What you think?Thanks for your reply.
I am not a doctor. I can certainly understand your worry. For many people, not just Hepatitis B patients, you will find the following is true:
"A hyperechoic liver lesion on ultrasound can arise from a number of entities, both benign and malignant. A benign hepatic haemangioma is the most common entity encountered, but in patients with atypical findings or a risk for malignancy, other entities must be considered."
A single "nodule" does not make cirrhosis. Since you have been under the care of a liver specialist and is now on treatment, chances of developing cirrhosis are very small. Also I am sure your specialist also monitors your AFP. At age 44 and early detection, even in the worst scenario, everything is in your favor. HCC if resectable is curable.
I think a haemangioma or cyst is the most probable finding.
"A hyperechoic liver lesion on ultrasound can arise from a number of entities, both benign and malignant. A benign hepatic haemangioma is the most common entity encountered, but in patients with atypical findings or a risk for malignancy, other entities must be considered."
A single "nodule" does not make cirrhosis. Since you have been under the care of a liver specialist and is now on treatment, chances of developing cirrhosis are very small. Also I am sure your specialist also monitors your AFP. At age 44 and early detection, even in the worst scenario, everything is in your favor. HCC if resectable is curable.
I think a haemangioma or cyst is the most probable finding.
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Thanks for your reply.But also says : "Echotexture corse". That's what concerns me the most.
"Coarse echotexture" is a special term, so you need the ultrasound doctor to explain its precise meaning. Personally, I would not be alarmed. Cirrhosis is best determined non-invasively by Fibroscan, not ultrsound.
Thanks again for your reply. Yes, in fact I was looking at some of the blood tests, and I found APT, which is a tumor marker, and is not abnormal , is 2.6 or 2.9 in a range of 0-9. Also says "N" on the abnormality section. You think this is a good sign?. I researched the AFT. Also I read in this same forum, that cirrhosis can be seen and diagnosed on an ultrasound already.
AFP is not a specific marker for HCC, but of course it is better to be normal than abnormal. Don't believe everything you read on this forum, including my comments. Always consult your own doctors.
Hello Stephen,
Yes you were right. From the MRI results,turned out to be a cyst,but the doctor said we need to do the MRI again in 3 months. But from the MRI, they (I think radiology) think might be a beginning of early cirrhosis. What you think?The doctor has ordered a test called 'Fibrospect 2),not " Fibroscan". Thanks for your reply.
Yes you were right. From the MRI results,turned out to be a cyst,but the doctor said we need to do the MRI again in 3 months. But from the MRI, they (I think radiology) think might be a beginning of early cirrhosis. What you think?The doctor has ordered a test called 'Fibrospect 2),not " Fibroscan". Thanks for your reply.
Good to hear that it is only a cyst. I don't know the reason for a second MRI, just guessing, it may have to do with the cyst rather than cirrhosis. I am not familiar with FibroSpect(II), it is a blood test and not known for detecting Fibrosis in HBV patients(HCV maybe). There are other blood tests such as APRI (aspartate aminotransferase [AST]-to-platelet ratio index) recommended by WHO in low resource countries. Fibroscan is now very common for assaying Fibrosis in HBV patients. Early cirrhosis is a rather vague description, but since you are on Viread and responding, it may be possible to revert any significant fibrosis over time.
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