Ultrasonography of the liver

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Author: Mikael Häggström [notes 1]

Ultrasonography of the liver is a type of ultrasonography of the abdomen.


Choice of modality

For the liver, the initial imaging of choice is generally as follows:

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:

Also, in suspected liver disease, it is often indicated to perform a general upper abdominal screening.


Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line, with some standard measurements.[4]
Normal craniocaudal dimension of the posterior surface of the right lobe of the liver at the midclavicular line at ages 0 to 7.[5]
  • 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:
  • Cranio-caudal dimension, which is normally up to 15 cm in adults.[4]
  • Ventro-dorsal dimension (or depth), which is normally up to 13 cm.[4]
  • Relative size of caudate lobe: In the axial plane, the caudate lobe should normally have a cross-section of less than 0.55 of the rest of the liver.[4]



  1. 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. 2.0 2.1 NU Hospital Group, Sweden


  1. 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:10.1093/gastro/gox012. ISSN 2052-0034. 
  2. Lincke, Therese; Zech, Christoph J. (2017). "Liver metastases: Detection and staging ". European Journal of Radiology 97: 76–82. doi:10.1016/j.ejrad.2017.10.016. ISSN 0720048X. 
  3. Maniam, Santhi (2010). "Magnetic resonance imaging: Review of imaging techniques and overview of liver imaging ". World Journal of Radiology 2 (8): 309. doi:10.4329/wjr.v2.i8.309. ISSN 1949-8470. 
  4. 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).
  5. 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:10.1590/S0100-39842009000100004. ISSN 0100-3984.