When hepatologists at Seattle Children’s see a child who is at high risk for nonalcoholic fatty liver disease (NAFLD) and whose blood test shows high liver enzyme levels, sometimes we perform an ultrasound. With ultrasound, we can see if there is fatty buildup (infiltration) in the liver. The presence of fatty buildup in the liver often indicates NAFLD, especially in patients with other risk factors such as obesity. Doctors can’t tell what stage the disease has progressed to from the ultrasound. Doing a liver biopsy is the only way to know for sure what stage the disease is in.
If the doctor finds no fatty buildup with the ultrasound, they look for other causes of liver inflammation such as infections, biliary atresia, metabolic disease or hepatitis.