Non-Invasive Diagnosis of Liver Fibrosis: Modern Instrumental Methods

Abstract

Liver fibrosis is a dynamic pathological process that develops in chronic liver diseases, the outcome of which can be cirrhosis. Biopsy remains the gold standard for diagnosing hepatic fibrosis, but non-invasive diagnostic methods are currently being actively introduced into clinical practice. Unlike liver biopsy, most noninvasive instrumental tests are simple to perform, accessible, and repeatable, making them more convenient for assessing fibrotic changes over time. The review summarizes the basic principles of methods for non-invasive instrumental assessment of the severity of liver fibrosis, studied and put into practice over recent years. The most widely used methods in clinical practice are based on the principles of elastography, which makes it possible to indirectly determine the density of organ tissue. The techniques are characterized by varying sensitivity and specificity in the diagnosis of fibrosis. The main problems arise when differentiating the stages of the disease. For some methods, restrictions on their use are ascites and excessively developed subcutaneous fat; for others, the high cost of the procedure. Meanwhile, there is every reason to believe that non-invasive techniques can take a major place in the diagnosis of liver fibrosis and replace biopsy in the near future.