Can liver be damaged w/ normal tests

[bravo1]

I am a 40 yr. old male in good health--I can run a mile in 8 minutes. I have been a moderate to heavy alcohol drinker for 20 years--average 60 g/d; however, I have gone through long periods of abstaination (one 2 year period and one 1 year period). I recently was diagnosed with 2 hemangiomas in my liver as an incidental finding on an MRI w/ and w/out contrast (the scan was ordered for a palpable mass on my chest wall on the outside of my ribcage right side which turned out to be nothing). The scan results state that the rest of the liver is normal, normal spleen, pancreas, bile ducts etc.--all normal. CBC is all normal. LFT test are normal: bilirubin=.9, albumin=4.9, ast=14, alt=14, alp=52.

My question is, "Is it posible or even likley that I have liver damage (fibrosis or cirrhosis) considering my alcohol use (or abuse)? Also, I noticed that the PT time and GGT were not tested for. Should I have these tests or a liver biopsy? I have no symptoms of liver damage.

[Dr. Safaa Mahmoud]

Hello,
MRI is highly sensitive and specific in the diagnosis of hepatic hemangioma. It is also very helpful in the identification of mild to severe liver fibrosis or cirrhosis.

Elevated liver enzymes at different levels of rise occur when there is a liver damage even in individuals with fatty liver.

Decompensated liver (extensive damage) results in abnormal liver function tests like low albumin, prolonged PT and low PC. In this stage there is usually a clear radiologic evidence for the liver damage and its probable cause like fibrosis, cirrhosis or malignancy.

Alcohol may result in fatty liver as well as cirrhosis in chronic alcoholics.

If you are asymptomatic, with normal liver function tests and enzymes as well as MRI results of accidentally discovered hemangioma, there is no need to think of liver damage by fibrosis or cirrhosis. Consequently, there is no indication for biopsy.

Hope you find this information useful.
Follow up with your doctor is essential.
Please keep us updated.
Best regards.