What can be detected by liver ultrasound

Liver ultrasound can detect the size, shape, parenchymal echo, vascular structure, space occupying lesions, and biliary system condition of the liver. This is a non-invasive and convenient imaging examination method commonly used to assess liver health status.

1. Liver size and morphology:

Ultrasound can clearly display the outline and size of the liver, whether it is within the normal range. If there is diffuse enlargement of the liver, it may be related to factors such as fatty liver, early viral hepatitis, or liver congestion, usually manifested as blunting of the liver margin and downward displacement of the lower liver margin. If the liver volume shrinks, it may be related to late stage cirrhosis or severe liver fibrosis, where the surface of the liver may appear nodular with irregular edges. The doctor will make a comprehensive judgment by measuring indicators such as the maximum oblique diameter of the right lobe of the liver and the thickness of the left lobe.

2. Liver parenchymal echo:

Normal liver parenchymal echo is uniform and appears as fine dots. When diffuse lesions appear, the echo will change. For example, in fatty liver, the echo of liver parenchyma will be enhanced and denser, and the echo behind will be attenuated; In chronic hepatitis or early cirrhosis, echoes may become thicker and unevenly distributed. If the echo changes in a "map like" or "grid like" pattern, one should be alert to cirrhosis or schistosomiasis liver disease. Doctors will assess the severity of the condition by combining echo intensity, uniformity, and attenuation.

3. Liver vascular structure:

Ultrasound can observe the course, diameter, and blood flow of the portal vein, hepatic artery, and hepatic vein in the liver. An inner diameter of the main portal vein exceeding 13 millimeters may indicate portal hypertension, which is commonly seen in cirrhosis. Narrowing, twisted course, or abnormal blood flow spectrum of hepatic veins also indicate liver cirrhosis or congestion. In addition, ultrasound can also detect blood clots or cancer thrombi within blood vessels, such as portal vein thrombosis or cancer thrombi formed by liver cancer invading blood vessels, which is very important for judging disease progression and selecting treatment plans.

4. Liver space occupying lesions:

Ultrasound has a high detection rate for intrahepatic space occupying lesions, and can detect nodules or masses with a diameter exceeding 1 centimeter. Common benign lesions include liver cysts, hepatic hemangiomas, and focal nodular changes, which typically have clear boundaries and regular morphology. Malignant tumors such as primary liver cancer or metastatic liver cancer are often characterized by unclear boundaries, irregular shapes, uneven internal echoes, and sometimes the presence of "halo" or "mosaic" signs. Ultrasound can also preliminarily determine the degree of blood flow richness in the occupied space, providing reference for distinguishing between benign and malignant.

5. Biliary system condition:

Ultrasound can simultaneously observe intrahepatic bile ducts and gallbladder. Intrahepatic bile duct dilation usually indicates biliary obstruction, commonly seen in common bile duct stones, cholangitis, or bile duct tumors. Thickening of the gallbladder wall by more than 3 millimeters may indicate cholecystitis, and if the gallbladder wall shows a "bilateral" sign, it indicates acute cholecystitis. In addition, ultrasound can also detect gallstones, gallbladder polyps, or gallbladder cancer. When the intrahepatic bile duct changes in a "withered tree branch" shape, the possibility of primary sclerosing cholangitis should be considered.

It is recommended to fast for at least 8 hours before undergoing liver ultrasound to reduce gastrointestinal gas interference. During the examination, it is necessary to cooperate with the doctor to perform breathing movements in order to display the liver structure more clearly. If ultrasound reveals abnormalities, doctors usually recommend further enhanced CT, magnetic resonance imaging, or liver biopsy to confirm the diagnosis. Keep a low-fat diet, control weight, avoid drinking alcohol, and regularly review liver function and liver color ultrasound, especially those with a history of hepatitis B, hepatitis C or fatty liver.