Can liver cirrhosis be diagnosed better with an ultrasound?

Hi doctor,

I am a 25-year-old and former heavy drinker who has reduced drinking in the past few months. I am also a diabetic type I patient who has good control over it with a healthy weight and normal blood pressure. I take insulin for diabetes type 1, Bricanyl inhaler which is used occasionally, and had injections of vitamin B12 and vitamin D supplement and tablet Sertraline 50 mg daily for the last six weeks. I had blood tests every six months with LFT having an increased level of bilirubin, albumin, and ALT. I recently had an ultrasound of the liver and was very worried as the ultrasound showed up mild cirrhotic liver changes. Although the ultrasound features depict the liver being in normal size and echotexture, with no HCC, and no liver lesions and portal veins and artery also showed ante-grade flow. Previously, also I had an MRI a few months back which depicted an enlarged right lobe with 172 mm homogeneous signal , with a bit enlarged liver with no signs of cirrhosis and no liver lesions in the scan. And I also had an ultrasound long back, it also showed normal liver. I am very anxious about my ultrasound report as its depicts cirrhosis but the previous reports showed up no cirrhosis. I want to know which is the better diagnosis and is liver really cirrhotic. What does 'mild' mean? Please give your opinion.

Hi doctor,

Thank you for your concern. I always have to go for a blood test every six months due to diabetes. A recent blood report is nearly two months back, in which hemoglobin was 129 g/l, total white cell count 5.7 K/uL, platelet count 275,000 mcL, AST serum 16 U/L. The liver function test includes serum total protein 74 g/L (normal range: 64 - 83); serum albumin 46 g/L (normal range: 35 - 50); serum ALT level 9 U/L (normal range: 10 - 35); serum alkaline phosphatase 61 U/L (normal range: 40 - 150); serum bilirubin level 9 umol/L (normal range: 0.0 - 21); serum globulin 28 g/L (normal range: 20 - 39) along with iron tests which include serum iron level 14.4 umol/L (normal range: 4.4 - 27.9); serum transferrin 2.18 g/L (normal range: 2.0 - 3.2); transferrin saturation index 26 % (normal range: 0 - 55) and urea and electrolytes that include serum sodium 139 mmol/L (normal range: 136 - 145); serum potassium 3.8 mmol/L (normal range: 3.5 - 5.1); serum urea level 1.6 mmol/L (normal range: 2.5 - 6.7); serum creatinine 48 umol/L (normal range: 50 - 98). I have also tested for the genetic disease hemochromatosis and the result was negative. I also have blood reports which are of the past six months. They include serum total protein 79 g/L (normal range: 64 - 83); serum globulin 31 g/L (normal range: 20 - 39); serum bilirubin level 19 umol/L (normal range: 0.0 - 21); serum ALT level 12 U/L (normal range: 10 - 35); serum alkaline phosphatase 57 U/L (normal range: 40 - 150); serum cholesterol 3.2 mmol/L; serum HDL cholesterol level 1.7 mmol/L; cholesterol/HDL ratio: 1.9; serum non-HDL cholesterol level: 1.5 mmol/L; along with these, there were GFR tests that include serum creatinine 49 umol/L (normal range: 50 - 98); serum prolactin level 329 mIU/L (normal range: 109 - 557) and urea and electrolytes that include serum sodium 140 mmol/L (normal range: 136 - 145); serum potassium 4.0 mmol/L (normal range: 3.5 - 5.1); serum urea level 2.4 mmol/L (normal range: 2.5 - 6.7).

Previous to these tests, all tests had a normal liver function. Yes, I do have some itchiness over my back, lower abdomen, and shoulder, which occurs when I am very stressed. A year back when I had no symptoms, my urine was pale and normal, no spider red veins, no swelling in my legs or abdomen, my HBA1C was 48, and my diabetes type 1 was good to moderate in control. So, my question is how can I develop cirrhosis in just a few months? And is the MRI more or less accurate than ultrasound for liver cirrhosis?