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LIVER, SCANNING technique | Normal Liver, Abnormal Liver | Acute Hepatitis , patient position

Hepatic Steatosis (Fatty Liver)
Hepatic Steatosis (Fatty Liver)
SCANNING TECHNIQUE



  • scanning should be in sagital, 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 visulaziation of the whole liver.

The patient lies supine.Apply coupling agent liberally,first over a right upper abdomen, then over the rest of the abdomen as the examinator proceeds.

 Choice of transducer  

Adult use a 3.5MHz transducer, for children or thin adults use a 5MHz transducer.


NORMAL LIVER

The normal liver parenchyma appears homogenrous. interrupted by portal vein and its branches which are seen as linear tublar structures with reflected walls. the linear heppatic viens are non-reflective. In a normal liver, it should be possible to follow the hepatic vein to their confluence with the inferior vena cava.



Abnormal liver

Enlarged liver/hepatomegally: homogenous pattern
 when the liver is enlarged but has a normal diffuses homogeneous echo pattern,consider the following:

congestive cardiace failure : 

The hepatic vein will be dialeted. The inferior vena cava does not vary on respiration. Look for a pleural effusion above the diaphragn.

Acute hepatitis
There are no characteristic sonographic changes, but the liver may be enlage and tender. Ultrasound is useful to exclude underlaying 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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