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| Hepatic Steatosis (Fatty Liver) |
SCANNING TECHNIQUE
scanning should be in sagittal, transverse, and oblique planes, including scans through the intercostal subcoastal spaces.
scanning should be done with slow rocking movement of the transducer in all planes to obtain the best visualization of the whole liver.
The patient lies supine. Apply the coupling agent liberally, first over the right upper abdomen, then over the rest of the abdomen as the examinator proceeds.
Choice of transducer
Normal Liver
The normal liver parenchyma appears homogeneous. interrupted by the portal vein and its branches which are seen as linear tubular structures with reflected walls. the linear hepatic veins are non-reflective. In a normal liver, it should be possible to follow the hepatic vein to its confluence with the inferior vena cava.
Enlarged liver/hepatomegaly: homogenous pattern
when the liver is enlarged but has a normal diffuse homogeneous echo pattern, consider the following:
Acute hepatitis
There are no characteristic sonographic changes, but the liver may be enlarged and tender. Ultrasound is useful to exclude underlying disease and, When the patient is jaundiced for differentiating between obstructive jaundice ultrasound does not usually give further useful information on hepatitis.
Tropical hepatomegaly
The only significant finding is liver enlargement, usually associated with splenomegaly.
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