Ultrasound

[pdr7686]

What does a Ultrasound show towards Hep C? If anyone could answer this I would greatly appreciate it.

[nygirl7]

Sounds like when I had a pneumothorax and was in the ER - the doc just took the knife cut between my ribs and stuck a huge tube through into my lung - nothing in my life EVER hurt that much. Not two csections, not breaking my back in two places, not treatment or migraines or broken bones - nothing. Urgh I have the heebie geebies now from the thought!

The ultrasound guided biopsy in the hospital..........was fine. click click click and it was over!

Make sure you get that one and not that one they are describing above....no way!

[mikesimon]

I had several biopsies similar to what you described. They were called bedside biopsies and the doctor would come into my hospital room with a tray. On the tray were three needles of graduating length, the longest being over 12 inches with a diameter like you described. I did get a local anesthetic just below the surface then a deeper anesthetic injection and then the big one through my ribs and into my liver. This was post transplant and I was so worried about the results that I may have simply ignored the pain. I know it wasn't anything like what I get now. Now I get an US guided biopsy with a spring loaded core retrieval gun and the sample is taken just below my sternum. There is a click sound like a nail gun and it's over. It is a totally different experience. During one of my bedside biopsies a doctor was being trained by his superior and she would ask if he palpated me and them tell him to do it and so on and so forth. I was about to say "Doc, you know so much why don't you do it" but again, my concern was the results. I probably had 4 bedside biopsies and once after the procedure the doctor dropped the glass vial which contained my tissue sample on the floor. Luckily it didn't break but when I saw it drop I thought - here we go again.
Mike

[Mr Liver]

Boy, are you right about the pain. Anyone who has ever had one done without the local anesthetic leading the way before the bx needle was introduced can testify to that. Like me. My first bx was 37 years ago in a military hospital. I wasn't told that it was even going to happen. It was about 8 pm and I heard steps coming. I looked up to see 1 doc and 2 medics. The medics were there in place of the local anesthetic I was soon to find out. The bx needle was about a foot in length and the needle was a little larger in diameter than an ink refill on a ballpoint pen.

The doc determined he was going to go between two ribs with the needle. While the medics held me down as the doc 'punched' ( it was actually designed so the doc can do this) the needle thru my cartilage. That really hurt. But not nearly as much as when the needle passed through the Glisson's capsule. The liver doesn't have pain nerves but the capsule is very rich in them and I experienced pain that hasn't been equaled too many times in my life. To make it worse, the whole thing was done twice as they couldn't retrieve a sample on the first try.

Everything about the procedure has changed since then but the capsule sure hasn't and if it isn't well anesthetized before the bx needle passes through it can produce terrible pain.

I know a few TP patients that have been very grateful to get rid of it as many can end up having countless bx after tp.
ML

[Mr Liver]

Ultra-sound can show the doc many things that a bx won'tshow, such as the spleen size, liver size, and nodules (which may or may not be tumors). It can also detect scarring (cirrhosis)  as well as blockages in liver blood vessels. Having an US first can save some patients for the need of a bx which carries risk. This list in not all-inclusive as there are other findings that can have diagnostic value when a liver/abdomen US is performed.

Mr Liver

[MIBunny55]

My liver was described as having irregular and somewhat lobulated borders and may be small in overall size.  "Evidence is seen for what I suspect are signs of cirrhosis involving the liver, splenomegaly, and ascites"  (Doctors impressions.) As I am still waiting for the appt with hepatologist, does anyone here have a clue as to what this means? I do have HCV, can't remember my genotype, but last pcr was 490,000. Did shorter term tx (6 month), too many bad reactions to sides.

[lalapple]

my hepa told me that ultrasound could measure the size of your liver to see if it is in the right place and is the right size.  however, for damage detection, it could only detect the last stage of liver damage bc by that time, the liver would have detectable bumps on the surface that can be detected from X rays and ultrasounds.
biopsy can show what stage of liver damage on a scale from 0-4 with 4 being the worst.  i never got one bc i knew i had the virus so why not get rid of it!

[mikesimon]

The biopsy was painless for you and all of mine have been easy too. Some people don't have such a painless procedure though. I would guess that for the majority of patients their biopsy was no big deal but others have said that they did experience some pain during or after the procedure.
Mike

[nygirl7]

it will show whether you have tumors or cancer or other damage like that.  It will NOT show what the level of fibrosis you have is. For example when the doctor said my ultrasound was perfect I thought I was fine. I didn't realize that my biopsy would show later that I had stage 3 liver damage.

You need to have both tests.....one is not sufficient unfortunately.

but the biopsy is painless - it's just like getting an injection, there are no liver cells inside your liver that would feel "pain".