ULTRASOUND THE LIVER
ULTRASOUND THE LIVER
The liver is a homogeneous, mid-grey organ on ultrasound. It
has the same, or slightly increased echogenicity when compared to the cortex of
the right kidney. Its outline is smooth, the inferior margin coming to a point
anteriorly .
The liver is surrounded by a thin, hyperechoic capsule, which
is difficult to see on ultrasound unless outlined by fluid.
The smooth parenchyma is interrupted by vessels (see below) and
ligaments and the liver itself provides an excellent acoustic window on to the
various organs and great vessels situated in the upper abdomen.
The ligaments are hyperechoic, linear structures; the falciform
ligament, which separates the anatomical left and right lobes is situated at
the superior margin of the liver and is best demonstrated when surrounded by
ascitic fluid. It surrounds the left main portal vein and is known as the
ligamentum teres as it descends towards the
infero-anterior aspect of the liver
The ligamentum venosum separates the caudate lobe from the rest
of the liver
The size of the liver is difficult to quantify, as there is
such a large variation in shape between normal subjects and direct measurements
are notoriously inaccurate. Size is therefore usually assessed subjectively.
Look particularly at the inferior margin of the right lobe which should come to
a point anterior to the lower pole of the right kidney .
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