Ultrasonography of the liver
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:
- Ultrasonography of the liver for suspected cirrhosis and/or portal hypertension.
- 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.
- MRI of the liver is indicated in hypervascular lesions that may represent a focal nodular hyperplasia (FNH).
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.
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.
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.
- Basic evaluation:
- Maximum dimension on a sagittal plane view through the midclavicular line, which is normally up to 18 cm in adults.
- More comprehensive, also including:
Ultrasonography of cirrhosis.
This image demonstrates irregular liver surface and ascites.
- 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.
- 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.
- 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.
- 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:10.1590/S0100-39842009000100004. ISSN 0100-3984.