Difference between revisions of "Ultrasonography of the liver"
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| + | Ultrasonography of the liver is a type of '''[[ultrasonography of the abdomen]]'''. | ||
| + | |||
| + | ==Planning== | ||
| + | {{Liver - choice of modality}} | ||
| + | ===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.<ref group="notes" name=NU>{{NU Hospital Group}}</ref> | ||
| + | |||
| + | 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.<ref group="notes" name=NU/> 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== | ==Size== | ||
[[File:Liver measurements on ultrasonography.jpg|thumb|Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line, with some standard measurements.<ref name=efsumb2010>{{cite web|url=http://www.kosmos-design.co.uk/efsumb-ecb/ecbse-ch02-ultrasoundliver.pdf|title=Ultrasound of the liver - EFSUMB – European Course Book|website=European federation of societies for ultrasound in medicine and biology (EFSUMB)|author=Christoph F. Dietrich, Carla Serra, Maciej Jedrzejczyk|date=2010-07-28}}</ref>]] | [[File:Liver measurements on ultrasonography.jpg|thumb|Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line, with some standard measurements.<ref name=efsumb2010>{{cite web|url=http://www.kosmos-design.co.uk/efsumb-ecb/ecbse-ch02-ultrasoundliver.pdf|title=Ultrasound of the liver - EFSUMB – European Course Book|website=European federation of societies for ultrasound in medicine and biology (EFSUMB)|author=Christoph F. Dietrich, Carla Serra, Maciej Jedrzejczyk|date=2010-07-28}}</ref>]] | ||
[[File:Liver size at the midclavicular line at 0 to 7 years.png|thumb|Normal craniocaudal dimension of the posterior surface of the right lobe of the liver at the midclavicular line at ages 0 to 7.<ref name="RochaFerrer2009">{{cite journal|last1=Rocha|first1=Silvia Maria Sucena da|last2=Ferrer|first2=Ana Paula Scoleze|last3=Oliveira|first3=Ilka Regina Souza de|last4=Widman|first4=Azzo|last5=Chammas|first5=Maria Cristina|last6=Oliveira|first6=Luiz Antonio Nunes de|last7=Cerri|first7=Giovanni Guido|title=Determinação do tamanho do fígado de crianças normais, entre 0 e 7 anos, por ultrassonografia|journal=Radiologia Brasileira|volume=42|issue=1|year=2009|pages=7–13|issn=0100-3984|doi=10.1590/S0100-39842009000100004}}</ref>]] | [[File:Liver size at the midclavicular line at 0 to 7 years.png|thumb|Normal craniocaudal dimension of the posterior surface of the right lobe of the liver at the midclavicular line at ages 0 to 7.<ref name="RochaFerrer2009">{{cite journal|last1=Rocha|first1=Silvia Maria Sucena da|last2=Ferrer|first2=Ana Paula Scoleze|last3=Oliveira|first3=Ilka Regina Souza de|last4=Widman|first4=Azzo|last5=Chammas|first5=Maria Cristina|last6=Oliveira|first6=Luiz Antonio Nunes de|last7=Cerri|first7=Giovanni Guido|title=Determinação do tamanho do fígado de crianças normais, entre 0 e 7 anos, por ultrassonografia|journal=Radiologia Brasileira|volume=42|issue=1|year=2009|pages=7–13|issn=0100-3984|doi=10.1590/S0100-39842009000100004}}</ref>]] | ||
| − | + | *Basic evaluation: | |
| − | + | :*''Maximum dimension'' on a sagittal plane view through the midclavicular line, which is normally up to 18 cm in adults.<ref name=efsumb2010/> | |
| + | *More comprehensive, also including: | ||
| + | :*''Cranio-caudal dimension'', which is normally up to 15 cm in adults.<ref name=efsumb2010/> | ||
| + | :*''Ventro-dorsal dimension'' (or ''depth''), which is normally up to 13 cm.<ref name=efsumb2010/> | ||
| + | :*''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.<ref name=efsumb2010/> | ||
==Diseases== | ==Diseases== | ||
<gallery> | <gallery> | ||
File:Ascites ultrasound 2.JPG|thumb|[[Ultrasonography of cirrhosis|Ultrasonography of '''cirrhosis''']].<br>This image demonstrates irregular liver surface and ascites. | File:Ascites ultrasound 2.JPG|thumb|[[Ultrasonography of cirrhosis|Ultrasonography of '''cirrhosis''']].<br>This image demonstrates irregular liver surface and ascites. | ||
| + | File:Contrast-enhanced ultrasound of encephaloid hepatocellular carcinoma.jpg|thumb|link=Ultrasonography of liver tumors|[[Ultrasonography of liver tumors|Ultrasonography of liver '''tumors''']] | ||
</gallery> | </gallery> | ||
| − | |||
{{Bottom}} | {{Bottom}} | ||
Latest revision as of 16:50, 15 July 2019
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
File:Liver measurements on ultrasonography.jpg
Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line, with some standard measurements.[4]
File:Liver size at the midclavicular line at 0 to 7 years.png
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:
Diseases
- Ascites ultrasound 2.JPG
Ultrasonography of cirrhosis.
This image demonstrates irregular liver surface and ascites. - Contrast-enhanced ultrasound of encephaloid hepatocellular carcinoma.jpg
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.
