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Liver - Sonography

ملتقى التصوير الطبي ( الأشعة )
عدد المعجبين  2معجبون
  • 1 أضيفت بواسطة عبدالله الشهري
  • 1 أضيفت بواسطة نسائم

موضوع مغلق
  #1  
قديم 09-26-2012, 11:31 PM
مشرف ملتقى التصوير الطبي ( الأشعة )
 




عبدالله الشهري will become famous soon enough


Liver is an organ which is very well viewable by sonography. We examine it by patient lying on his back or on his left hip (better image of Liver hilum). Liver is examined by fan-shape movement by probe in both sagittal and transverse plain. Liver is much more visible during inspiration.
Liver hilum (portal vein, common bile duct, hepatic artery) is displayed in right subcostal space. The probe is rotated from transverse plain for approximately 45° clockwise.

Important numbers:
Liver width: under 14cm (We measure after expiration in right sagittal medioclavicular line)

Portal vein width: under 13-15mm (We measure approximately 1.5cm before its intrahepatal bifurcation, sometimes we measure near place where portal vein enters liver parenchyma.)

Common bile duct width: under 6mm (or under 9mm after cholecystectomy)

Hepatic veins width: under 6mm for peripheral hepatic veins, under 10mm liver veins before entering the inferior vena cava.

Liver Sonography Liver_Ultrasound.jpg
Liver width is measured in right middle medioclavicular
line. This cut also often displays right kidney.


Liver vessels - Liver veins – Anechogenic x Portal vein branches – They have 2 hyperechogenic bright "rails" in their wall (intrahepatal bile ducts)

Liver Sonography Liver_Vessels_Ultrasound.jpg
Differentiation of liver veins from portal branches


Liver hilum – It is the entrance of hepatic artery, portal vein and departure of common bile duct from liver. In this area we can measure the width of portal vein and most importantly the width of the bile duct. It is common that bile duct and hepatic artery are located above the portal vein. We can differ them by using Doppler sonography. Hepatic artery shows blood flow, bile duct does not.

Liver Sonography Liver_Hilum_Ultrasound_0.jpg
In liver hilum we see portal vein entering the liver. Two slim lines above portal vein
is hepatic artery and bile duct. In this static picture without the possibility to check
the blood flow it is practically impossible to differentiate them.


Portal hypertension – Portal vein is broader than 15mm, we also find splenomegaly and often ascites (anechogenic black fluid in abdominal cavity).


Liver congestion by right-sided heart failure – We find dialted peripheral hepatic veins over 6mm. We can sometimes find fluid in pleural cavity above the diaphragm.

Liver Sonography Dilated_Hepatic_Veins_Ultrasound.jpg
Dilated hepatic veins – Peripheral veins are broader than 6mm, veins
near influx into inferior vena cava are wider than 10mm.


Liver steatosis – The liver echogenity is higher than normal. Liver parenchyma becomes brighter than right kidney parenchyma. In sagittal projection we can easily display both organs and make a comparison.

Liver Sonography Liver_Steatosis_Ultrasound.jpg
Liver steatosis – There is a clear difference between
the echogenity of liver and right kidney parenchyma


Liver cysts – It is a very common finding. They are anechogenic black round regular objects inside the liver parenchyma. Often we can see a conic bright shadow behind them (acoustic amplification).

Liver Sonography Liver_Cyst_Ultrasound.jpg
Liver cyst – It is a regular anechogenic round
structure with a conic bright shadow behind it.


Liver hemangioma – They are displayed as distinctly bordered hyperechogenic areas.

Liver Sonography Liver_Hemangioma_Ultrasound.jpg
Liver hemangioma - Well bordered, hyperechogenic


Liver cirrhosis – By liver cirrhosis we find irregular rough liver margins (macronodular or micronodular cirrhosis). Liver veins connect in open angles. Parenchymal echogenity is higher and the tissue seems to be granular. In advanced stages of the cirrhosis liver size dwindles and we find marks of portal hypertension (ascites, portal vein dilation, splenomegaly).

Liver Sonography Liver_Cirrhosis_Ultrasound.jpg
Liver cirrhosis – We see bright parenchyma of the liver,
rough liver margins and ascites in the surroundings.


Common bile duct dilation - It is a very imporntant finding and means dilation of bile duct over 6mm (or over 9mm by patients after cholecystectomy). The most common causes are gallstones and local tumours. The ultrasound, however, does not always find the cause.

Liver Sonography Bile_Duct_Dilatation_Ultrasound.jpg
Bile duct dilation – It is a pity I was not able to find such a great picture in better quality.
We see liver hilum with portal vein and dilated bile duct. In this case we also see the reason
of the dilation – bright gallstone with dorsal acoustic shadow obstructing the bile duct.


Liver tumours – It is a bearing of different echogenity from surrounding parenchyma. It often oppresses neighbouring liver tissue.

Liver Sonography Liver_Tumour_Ultrasound.jpg
Primary tumour – This object could be also a metastasis. However,
the patient was later diagnosed with a hepatocellular liver carcinoma.


Liver metastases – They are bearings of different echogenity than liver tissue. They have typically a hypoechogenic margin (halo).

Liver Sonography Liver_Metastases_Ultrasound.jpg
Liver metastases I – Few bigger metastases with hypoechogenic margins

Liver Sonography Liver_Metastases_Kidney_Cyst_Ultrasound.jpg
Liver metastases II – Liver parenchyma is full of small metastases. Furthermore
there is a renal cyst, which is a casual (and in this case probably insignificant) finding.
شارك
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الكفاح معجبون بهذا.


من مواضيعي : عبدالله الشهري
  رقم المشاركة : [ 2 ]
قديم 10-01-2012, 01:04 PM
صحي جديد
 

ABU ZOZO will become famous soon enough
افتراضي رد: Liver - Sonography

صور جداً ممتازه ومفيدة يعطيك العافية
من مواضيع : ABU ZOZO
ABU ZOZO غير متواجد حالياً  
  رقم المشاركة : [ 3 ]
قديم 10-17-2012, 01:52 AM
مشرف ملتقى التصوير الطبي ( الأشعة )
 

عبدالله الشهري will become famous soon enough
افتراضي رد: Liver - Sonography

هلا بك اخي abo zozo
واشكرك على تواصلك وفقك الله
من مواضيع : عبدالله الشهري
عبدالله الشهري غير متواجد حالياً  
  رقم المشاركة : [ 4 ]
قديم 11-20-2012, 08:29 PM
المشرف العام

الصورة الرمزية نسائم
 

نسائم will become famous soon enoughنسائم will become famous soon enough
افتراضي رد: Liver - Sonography



يعطيك العافية
بارك الله فيك وألف شكر



عبدالله الشهري معجبون بهذا.
من مواضيع : نسائم
نسائم غير متواجد حالياً  
  رقم المشاركة : [ 5 ]
قديم 11-22-2012, 06:24 PM
مشرف ملتقى التصوير الطبي ( الأشعة )
 

عبدالله الشهري will become famous soon enough
افتراضي رد: Liver - Sonography

اقتباس
  المشاركة الأصلية كتبت بواسطة نسائم


يعطيك العافية


بارك الله فيك وألف شكر





حياكي الله اخت نسائم وبارك الله فيك على المرور الكريم
من مواضيع : عبدالله الشهري
عبدالله الشهري غير متواجد حالياً  
  رقم المشاركة : [ 6 ]
قديم 12-23-2015, 04:08 PM
صحي جديد
 

Lamia Abdullah will become famous soon enough
افتراضي رد: Liver - Sonography

أشكركَ .. الموضوع جداَ مفيد !
وجميل .. استفدت منه كثير صرأحه ..
Lamia Abdullah غير متواجد حالياً  
  رقم المشاركة : [ 7 ]
قديم 04-10-2016, 09:59 PM
مشرف ملتقى التصوير الطبي ( الأشعة )
 

عبدالله الشهري will become famous soon enough
افتراضي رد: Liver - Sonography

اقتباس
  المشاركة الأصلية كتبت بواسطة lamia abdullah
أشكركَ .. الموضوع جداَ مفيد !
وجميل .. استفدت منه كثير صرأحه ..

شكرا لك وفقك الله وبارك فيك
من مواضيع : عبدالله الشهري
عبدالله الشهري غير متواجد حالياً  
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