Overview
Clinical Meaning
Diagnosing cirrhosis has evolved from mandatory liver biopsy (Metavir F4) to validated non invasive methods.
WHNP
WHNP
Diagnosing cirrhosis has evolved from mandatory liver biopsy (Metavir F4) to validated non-invasive methods. FibroScan (transient elastography) measures liver stiffness using ultrasound-based shear wave velocity: <7 kPa is normal, 7-12.5 kPa suggests significant fibrosis, >12.5 kPa suggests cirrhosis (with >95% NPV for ruling out advanced fibrosis). Serum biomarker panels include FIB-4 (combining age, AST, ALT, platelets; >3.25 suggests advanced fibrosis), APRI (AST-to-platelet ratio index), and enhanced liver fibrosis (ELF) test. The Child-Pugh classification (A=5-6, B=7-9, C=10-15) uses bilirubin, albumin, INR, ascites, and encephalopathy to stage functional severity. The MELD score (using bilirubin, INR, creatinine) predicts 3-month mortality and determines transplant priority.
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