Ultrasound of the liver is a diagnostic study that visualizes the structure of the liver, hepatic vessels, gallbladder, bile ducts. It is used as part of a comprehensive diagnosis, reveals signs of hepatitis, steatohepatosis, liver cirrhosis, cholelithiasis, Budd-Chiari disease, liver metastases and neoplasms. There are several options for the procedure: liver ultrasound, liver ultrasound + gallbladder, liver ultrasound + vascular Dopplerography.
Preparation
To improve the accuracy of the image and obtain reliable results, it is recommended to start special training 3-4 days before the diagnosis. It includes the following activities:
- Correction of nutrition. It is necessary to exclude gas-forming products from the diet: raw vegetables and fruits, rye bread, legumes, confectionery, carbonated drinks. It is necessary to give up alcohol and spicy dishes.
- Reception of enterosorbents, enzymes. Patients with a tendency to increased gas formation are shown prophylactic intake of activated carbon, carminative and enzyme preparations. In some cases, the doctor prescribes a cleansing enema, taking laxatives.
- Cancellation of gastro- and colonoscopy. Endoscopic examinations of the digestive tract can cause contractions and spasms of the bile ducts, gallbladder. This will distort the real picture and make it difficult to make a diagnosis.
The period of hunger. Ultrasound of the liver is performed on an empty stomach. Adult patients should refrain from eating 8-12 hours before the procedure. In young children, the duration of hunger is reduced to 6-8 hours, in breastfed infants – up to 3 hours, on artificial nutrition – up to 4 hours (exclude complementary foods). Children are allowed to drink water without additives.
What shows
Ultrasound of the liver allows you to study the structure and features of the functioning of the organ: its size, location, structure of individual lobes. A comprehensive ultrasound examination of the liver and gallbladder makes it possible to assess the condition of the liver, as well as the biliary system – the bladder itself, the hepatic duct and the sphincters responsible for the promotion of bile. Ultrasound of the liver in combination with ultrasound Dopplerography of the vessels, along with the structure of the organ itself, reflects the state of blood flow, the integrity and thickness of the vascular walls, the diameter of the lumen and the tortuosity of the arteries, veins and capillaries.
Normally, the liver has a fine-grained structure, moderate brightness with a uniform distribution of moderate echogenicity signals. Ultrasound is prescribed to clarify the diagnosis with an ambiguous clinical picture. According to the results of the procedure , the following pathologies are revealed:
- Inflammatory processes. Inflammation accompanies chronic hepatitis and cholelithiasis. The ultrasound image shows diffuse changes in the entire surface of the liver, an uneven and wavy contour.
- Cirrhosis. At the initial stages of the disease, the size of the organ is increased, later it is reduced due to cell death. There may be an imbalance in the size of the right and left parts. The surface of the organ is uneven, knobby, the architectonics of the vessels is changed, the tissues are sclerosed.
- Hepatitis. There is an increase in the liver, heterogeneity of the structure and swelling of tissues. There may be signs of inflammation, fibrosis, and a decrease in tissue density.
- Budd-Chiari disease. A violation of the outflow of blood from the liver, tortuosity and narrowing of the lumen of the hepatic veins is diagnosed. A characteristic feature is an increase in the size of the caudate lobe.
- Liver neoplasms, metastases. Benign and malignant neoplasia – tumors, cysts, lipomas, metastases – are displayed as foci with different echogenicity (more often increased). Volumetric neoplasms lead to swelling of the organ surface.
- Fatty liver dystrophy. It develops with alcoholism, diabetes mellitus, and other metabolic diseases. The echogenicity of the affected organ is increased, regional, segmental and focal parenchymal changes are possible, localized mainly proximally from the zone of the fossa of the gallbladder and bifurcation of the collar zone.
Ultrasound results are often not specific enough to accurately determine the disease, so they are not used for diagnosis in isolation. The revealed pathological changes are considered in combination with the clinical picture, anamnesis and laboratory blood tests (bilirubin, liver enzymes, leukocytes).
Advantages
Ultrasound diagnostic rooms are widely used in both public and private clinics, which makes the procedure accessible to most patients. Ultrasonic scanners and sensors are safe, transmit high-quality images. Ultrasound can be repeated many times without harm to the patient’s health, has no contraindications for examination of pregnant women, newborns, infants and the elderly. With the low cost of the ultrasound procedure, its disadvantage is the limitation of ultrasound waves directed by the sensor: there are “blind” zones, the image resolution is lower than with liver MRI and CT.
