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Elastography
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Elastography

Elastography is an imaging test used to detect liver stiffness, which is a key indicator of fibrosis (scar tissue) caused by chronic liver disease.

Overview

Elastography checks organs for abnormal stiffness. It is primarily used to assess the liver for fibrosis, which occurs when the liver is damaged over time and forms scar tissue during the healing process. Common causes include Hepatitis B and C, Alcohol use disorder (AUD), and Nonalcoholic fatty liver disease (NAFLD).

If left untreated, fibrosis can progress to cirrhosis, where scarring becomes permanent and can lead to liver failure or liver cancer.

Types of Elastography

  • Ultrasound elastography (transient elastography): Uses sound waves to send vibrations into the liver. A computer measures how fast these vibrations move to create an image of tissue stiffness.
  • Magnetic resonance elastography (MRE): Uses an MRI machine to map liver stiffness using magnetic resonance imaging.

Why do I need an elastography test?

You may need this test if you have a liver condition, abnormal liver test results, or risk factors for cirrhosis, such as:

  • Alcohol use disorder.
  • Type 2 diabetes.
  • Chronic hepatitis B or C.
  • Autoimmune or genetic disorders.
  • Long-term use of certain medications.

What do the results mean?

Results are typically provided as a fibrosis score:

  • F0 to F1: Normal; little or no scarring.
  • F2: Moderate scarring.
  • F3: Severe scarring.
  • F4: Cirrhosis (very severe scarring).

The test also provides a CAP score, which measures the percentage of fat in the liver. A normal liver contains 5% fat or less; higher percentages indicate fatty liver disease.

Preparation & Risks

There are no known risks to ultrasound elastography. MRE carries little risk, though patients should inform their provider if they have metal implants or devices, as the MRI scanner uses powerful magnets. Patients may be asked to fast for several hours before either procedure.

Frequently Asked Questions

Generally no fasting is required, but you should avoid heavy meals within 2 hours of the test to reduce liver congestion; inform the technologist of any anticoagulants or recent contrast agents, although they rarely affect the measurement.
n F3 score indicates severe scarring but not yet cirrhosis; most hepatologists will intensify antiviral therapy, recommend lifestyle changes (e.g., alcohol abstinence, weight loss), and schedule more frequent monitoring for progression to F4.
Elastography is non‑invasive, painless, and provides an immediate stiffness measurement; while it correlates well with biopsy‑derived fibrosis stages, it cannot assess microscopic inflammation or early cellular changes that a biopsy might reveal.
In high‑BMI individuals, the ultrasound probe may have limited penetration, potentially leading to “failed” readings; in such cases, magnetic resonance elastography (MRE) is preferred because it is less affected by body habitus.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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