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Liver disease: Overview of ultrasound findings

by Dr Pandula Siribaddana

Ultrasound scanning is a non invasive technology used in diagnosing many diseases involving the organs within the body. The commonest areas which are being scanned are the abdomen and the pelvis, while the liver is one of the organs that can be seen clearly using this technique.

The mechanism:

The mechanism of Ultrasound Scanning is based on the transmitted sound waves of specific frequency being reflected by the organs which are present in the body. Depending on the consistency of the tissues as well as the content surrounding and filling an organ structure, the time and frequency of the returning sound waves will vary. Thus, this variation would be decoded by the machine in order to generate a relevant image which can be interpreted by an experienced radiologist or a health care professional.

What can be seen in the liver?

Similar to other structures, the liver is also in possession of such varying degree of ultrasonic reflection according to the structure that is being aimed at. Thus, the appearance of the parenchyma of the liver can be demarcated from the appearance of the blood vessel wall or else the billiary tree. It's also possible to identify the different lobes as well as the surrounding capsule of the liver. The size is another entity that can be demonstrated using an ultrasound scan along with its relationship to other surrounding structures. In general, the researches have identified that the appearance of size, border, liver angle, parenchyma of the liver, posterior surface, portal vein wall and gallbladder wall findings will contribute to an accurate diagnosis of many of the diseases.

What changes can take place in liver disease?

In liver disease, the appearance will vary from the normal. Thus, for a person to interpret the abnormal appearances of the liver, they need to first know the normal appearance. For such experienced persons, giving an opinion through ultrasound imaging would not be a difficult task.

For instance, in cirrhosis of the liver, an ultrasound scan will show a small nodular appearance with increased echogenicity of the lung parenchyma with irregular patterns. In portal hypertension the findings may be that of a dilated portal vessel wall with increased amounts of blood flowing in the portal tract. In abscesses and cysts, the echogenicity will demarcate a well circumscribed area with either high or low echogenicity depending on the material and organisms that are present. In other instances, the liver may only show signs of presence of fat lobules or else changes in its size and shape where the radiologists would have to make assumptions based on the clinical history.

Thus, ultrasound examination of the liver would be one of the preliminary diagnostic tools as well as relatively cheaper alternative to much fancied high contrast imaging studies that will make the diagnosis complete.

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