Ultrasound examination of the liver allows to determine the features of the organ. It is conducted in the presence of symptoms of certain diseases, as well as with a preventive goal for people at risk.
ultrasound is a kind of diagnostic procedure, when using the interaction of the device it becomes possible to study the structure of the liver. The method is reliable, it allows to determine individual indicators and parameters.
Anatomy
The liver is one of the largest organs. Its size and weight vary with age.
In an adult human body weight varies between 1300-1800 grams. In newborn babies, it takes up almost half of the abdominal cavity.
The body is covered on all sides by the peritoneum. The exception is the gate and the back of the surface. The parenchyma is covered with a fibrous membrane.
The body is responsible for:
- Digestion. plays an important role in the production of bile.
- Metabolism. All blood passes through the hepatic portal vein. It is responsible for the assimilation of carbohydrates, lipids, proteins and their transformation into biologically useful materials.
- Detoxification. Hepatocytes control the quality of blood, remove toxic compounds from it.
Indications
Most often the procedure is carried out by the elderly, since over the years serious organ pathologies may appear. Indications for the procedure are:
- Yellowness of the skin, eyes and mucous proteins.
- Staining of urine in bright color with simultaneous decolorization of fecal masses.
- Prolonged treatment with the use of serious medications.
- Radiation exposure to the body and chemotherapy.
- Abdominal pain on the right side.
- Appearance of a feeling of heaviness after eating.
- Severe abdominal trauma.
A procedure is also designed to clarify the presence and size of the inflammatory focus in the liver, which was found after other methods of investigation. Sometimes there is a suspicion of an abscess in the organs. The
ultrasound can determine the diameter and size of the organ, detect abnormalities and analyze the tissue structure.
Contraindications
The procedure is painless, does not imply an aggressive effect on the body by the introduction of special preparations and liquids. Examination is carried out on an outpatient basis.
Absolute contraindications to it are not present, but research is transferred if the patient accepted preparations which can change a clinical picture. Possible the appearance of infectious diseases of the skin in the projection zone of the liver. Then, to prevent the spread of the disease, the date of the ultrasound is postponed.
Contraindications include the use by the patient of alcoholic beverages, food, which cause the flatulence. In this case, the possibility of making an erroneous diagnosis increases.
Preparation of the patient for the procedure
It is necessary for obtaining more accurate information about human health. At the time of examination, there should be no gas in the intestine, therefore it is recommended to check on an empty stomach or with a change in the diet.
Few days before ultrasound excludes cellulose, cabbage, whole milk, legumes, fruits and bread.
Sometimes a doctor prescribes sorbent reception and setting an enema. To reduce the amount of gases in the intestines will help drugs such as Smecta, Activated Carbon, Espoumezan. It is possible to take enzyme preparations, for example, Pancreatin and Creon.
Video on how to prepare for ultrasound of the liver:
Procedure for
The duration of the procedure is from 15 to 30 minutes. The person is laid on the couch in the supine position. Sometimes the doctor may ask for a different position.
After the procedure, you can immediately go back to your daily business, get behind the wheel of the car. In emergency situations, ultrasound of the liver is performed without preparation.
Normal body size in adults and children
The dimensions of a healthy liver in adults are as follows:
- The thickness of the right lobe is 110-130 cm, the length is 110-150 mm.
- The maximum vertical slant size is up to 150 mm.
- The thickness of the left lobe is 50-70 mm, the height is up to 100 mm.
When studying the dimensions, homogeneity, sharpness of the contour, and the state of the veins are immediately taken into account. Liver in men and women has the same parameters. In this case, the maximum size of the hepatic artery reaches a maximum of 13 mm, the portal vein - 11-18 mm, the hepatic veins up to 10 mm.
In children, the age is taken into account in the examination:
| Age | Right share | Left share |
|---|---|---|
| 1-2 years | 60 | 33 |
| 5-6 years | 84 | 41 |
| 9-10 years | 100 | 47 |
| 13-18 years | 100 | 50 |
But these data are informational in nature, since the deviations and features canjudge only a hepatologist or general practitioner.
What shows ultrasound of the liver: a transcript
The structure is necessarily evaluated. The edge of the liver should be even. After this, the size of the shares is examined. After this, the parenchyma of the gland is subjected to analysis for the presence of nodes, seals and calcifications that form the changes of the signal arriving at the apparatus.
On strengthening or weakening of ultrasonic waves, the physician of functional diagnostics recognizes the presence of liquid and dense formations.
Developmental anomalies
With the help of the ultrasound apparatus, a large number of abnormalities can be detected, including congenital liver hypoplasia in children.
The hardware diagnostic method allows to determine:
- Agenesis of the right lobe of the liver and left. The latter is more frequent. In case of illness, one or more of the parts is missing. Additionally, other diagnostic methods are used to diagnose the diagnosis.
- Share of Riedel. It is characteristic for her to change the shape of the organ. A doctor can detect the formation of a linguistic form.
- Additional shares. They are located above the diaphragm or in the hernial sac. The main organ is connected by fibrous strain.
- Cystic and polycystic diseases.the latter appear on the walls of the organs with intrauterine development. Diseases may not manifest themselves for many years.
Diffuse parenchymal changes
With advanced processes, they indicate the presence of a serious pathological process. Anomalies and changes in hepatic tissues can occur with violations and severe organ damage.
Usually, with diffuse changes in the parenchyma, deformation or thinning of the parenchyma walls and surrounding tissues is formed. This leads to a violation of the integrity and normal functioning of the liver.
Cysts
This is a focal cavity change in the liver, manifested by pain, asymmetry of the abdomen, nausea. Using ultrasound, you can find such benign formations in various segments, lobes and ligaments of the liver. The diameter is usually from a few millimeters to 25 cm.
In the liver, cysts are found in 0.8% of the population. Women are more common than men. This disease is often combined with cholelithiasis, cirrhosis, polycystic ovaries.
Congenital
This type is formed as a result of impaired development of ducts. It turns out to be blocked, so bile can not get out of it. Gradually, the cavity is formed. The pressure increases so much that the further supply of the liver becomes impossible.
Congenital cysts have their own capsule. This they differ from other types. On ultrasound, you can identify both single and multiple forms.
Liquid formations are usually anaedogenic. If the fluid is heterogeneous, then the echogenicity can be different.
Echinococcal
Echinococcosis is a disease of the liver of parasites, tapeworms. Sometimes the disease runs without symptoms, so it is detected accidentally with ultrasound. The echinococcal cyst is initially located in the liver.
There are two forms of the disease:
- The hydrated species has the shape of cysts.
- Alveolar - with tumor formations.
Sometimes both types are combined. On ultrasound, the doctor will see rounded, restricted areas of altered liver tissue that contain liquid. In addition, an immunological study is assigned to clarify the diagnosis.
Traumatic
They are spherical or oval in shape, free from echoes. Traumatic develops after central or subcapsular rupture of the liver, may appear after treatment of liver abscess.
This kind of benign formation appears with severe bumps, falls, and broken ribs.
Tumor Education
With the help of ultrasound of the liver, it is possible to identify both benign and malignant tumors.
The first type is adenoma. It looks on the device as a simple education with smooth contours.
Hemangiomas are formed from the vascular tissue. On ultrasound, the picture is represented by formation with uneven contours and a heterogeneous structure.
Liver cancer can be detected. This is a fatty tumor that is similar to haemannoma and metastases. A rare formation is biliary cystadenoma. On ultrasound it is visible, that walls of a cyst have a rich blood supply and multiple papillary foci.
In malignant tumors, ultrasound confirms the presence of dense formations. The method allows to establish the presence of such dangerous diseases as carcinoma, angiosarcoma, hepatoblastoma. At the primary lesion, the ultrasound picture is diverse.
Suspicion for the presence of a tumor can cause:
- seals in the zone of the portal vein branches,
- changes in the vascular pattern,
- organ size increase,
- rounding of the lower edge,
- effect of weak ultrasound conduction.
Due to the attenuation of ultrasonic waves, the image of the diaphragm becomes blurred.
Why is the organ enlarged?
The increase in the liver is said when its size at the intersection of the organ with the right sredneklyuchichnoy line starts from 12 cm, and the left share is in the epigastric region. This formation can provoke both education and education:
- infectious liver lesions,
- alcoholic organ damage,
- hepatitis,
- cirrhosis,
- lipid metabolism disorder,
- heart failure,
- parasites,
- cholelithiasis.
It is possible to suggest an increase in the appearance of gravity in the right side, emotional instability, discoloration and stool. Dangerous consequences are oncological processes, cirrhosis and the development of liver failure.
The concept of granularity
The liver consists of cells that are slightly flattened. Due to this, one can speak of the porous structure of the organ. This is necessary for the full work of the body.
Normally, the internal structure of the liver is fine-grained and soft.
Pathological processes develop gradually.
First, there is a medium-grained or coarse-grained texture. The latter indicates the appearance of hepatitis, severe obesity or the presence of diabetes.
With ultrasound, you can see a significant increase in segments of the structure of the liver and heterogeneity of the lymph nodes.
Elastography study
This method is used to assess the severity of fibrosis. At usual US the first stages of a fibrosis, a cirrhosis and a hepatitis look or appear equally. Previously, a liver biopsy was used to establish an accurate diagnosis. This procedure is expensive, has many side effects.
The elastographic technique allows an adequate diagnosis. Transient ultrasonic elastometry is performed through intercostal spaces.
The special apparatus has an ultrasonic sensor with a source of low-frequency oscillations. They reach the right tissues and then transform into electromagnetic waves. This method determines the speed of wave distribution, which depends on the elastic component.
The method synchronously performs two modes, due to which you can see the ultrasound picture of the liver and color mapping, assessing tissue density. This method of investigation gives a complete picture of the pathological process developing in the liver.
Where can I make a survey?
Conducting the usual ultrasound of the liver can be done both in the polyclinic and during the treatment in the hospital. Usually the procedure should be recorded in advance at the reception or through the site of the selected institution. Diagnosis is also carried out in various medical centers that exist in all major cities.
Cost of
The most expensive method of investigation is ultrasound with elastography. In Moscow and St. Petersburg, two or three years ago it could be passed for 7 thousand rubles. Today the prices are more democratic, so on average the procedure will cost 4 thousand.
Prices for classical ultrasound start at 700 rubles.