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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