Ultrasonography of the liver
Author:
Mikael Häggström [notes 1]
Ultrasonography of the liver is a type of ultrasonography of the abdomen.
Contents
Planning
Choice of modality
For the liver, the initial imaging of choice is generally as follows:
- Ultrasonography of the liver for suspected cirrhosis and/or portal hypertension.[1]
- CT of the liver, often as part of a general abdominal CT, is generally the investigation of choice to look for metastases of recently diagnosed cancers in the abdomen.[2]
- MRI of the liver is indicated in hypervascular lesions that may represent a focal nodular hyperplasia (FNH).[3]
Settings and expansions
Contrast-enhanced liver ultrasonography is often indicated in cases of focal liver changes, as well as follow-ups of metastases. In Swedish practice, it should be performed within 2 to 4 weeks, depending on the supiciousness of cancer.
Ultrasonography of cirrhosis is done without IV contrast. In Swedish practice, it should be done within 2 months in suspected cirrhosis.[notes 2]
In abnormal liver function tests without pain, a combined ultrasonography of the biliary tract and liver is indicated. In Swedish practice, it should be done within 4 to 8 weeks.[notes 2] If concurrent pain, consider ultrasonography of gallstones.
General screening
A general screening of the liver includes:
- Echogenicity, where being more hyperechogenic than the kidneys indicates steatosis. If found, see Ultrasonography of steatosis
- Focal changes, mainly cysts or tumors. In case of a suspected tumor, see ultrasonography of liver tumors
Also, in suspected liver disease, it is often indicated to perform a general upper abdominal screening.
Size
- Basic evaluation:
- Maximum dimension on a sagittal plane view through the midclavicular line, which is normally up to 18 cm in adults.[4]
- More comprehensive, also including:
Diseases
Ultrasonography of cirrhosis.
This image demonstrates irregular liver surface and ascites.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
- ↑ 2.0 2.1 NU Hospital Group, Sweden
References
- ↑ Procopet, Bogdan; Berzigotti, Annalisa (2017). "Diagnosis of cirrhosis and portal hypertension: imaging, non-invasive markers of fibrosis and liver biopsy ". Gastroenterology Report 5 (2): 79–89. doi:. ISSN 2052-0034.
- ↑ Lincke, Therese; Zech, Christoph J. (2017). "Liver metastases: Detection and staging ". European Journal of Radiology 97: 76–82. doi:. ISSN 0720048X.
- ↑ Maniam, Santhi (2010). "Magnetic resonance imaging: Review of imaging techniques and overview of liver imaging ". World Journal of Radiology 2 (8): 309. doi:. ISSN 1949-8470.
- ↑ 4.0 4.1 4.2 4.3 4.4 Christoph F. Dietrich, Carla Serra, Maciej Jedrzejczyk (2010-07-28). Ultrasound of the liver - EFSUMB – European Course Book. European federation of societies for ultrasound in medicine and biology (EFSUMB).
- ↑ Rocha, Silvia Maria Sucena da; Ferrer, Ana Paula Scoleze; Oliveira, Ilka Regina Souza de; Widman, Azzo; Chammas, Maria Cristina; Oliveira, Luiz Antonio Nunes de; Cerri, Giovanni Guido (2009). "Determinação do tamanho do fígado de crianças normais, entre 0 e 7 anos, por ultrassonografia ". Radiologia Brasileira 42 (1): 7–13. doi:. ISSN 0100-3984.
