liver ultrasound

Ultrasound testing is the preferred method of examination for various liver diseases. Two-dimensional real-time ultrasound imaging is mainly used for liver morphology changes, and two-color Doppler flow imaging is used for hepatic vascular lesions and hemodynamic examination. Ultrasound examination revealed a lesion image of the liver that is a property of acoustic physics. In the same lesion, the different stages of the course of disease development, the ultrasound images behave differently; while the different acoustic lesions have similar acoustic and physical properties, the ultrasound images may behave the same. Ultrasound therefore does not suggest a diagnosis of pathological anatomy. Ultrasound testing of a small portion of hepatic space-occupying lesions does not identify benign or malignant, such as diffuse cirrhosis and diffuse liver cancer. Some intrahepatic nodules are difficult to distinguish between inflammatory or tumor. Liver interventional biopsy or other tests may be performed in the presence of ultrasound when necessary. Basic Information Specialist classification: Digestive examination classification: liver function test Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: A negative test result indicates that the subject should be in a normal state. Positive: Positive results suggest that you may have liver disease. Tips: On the day of ultrasound examination, barium meal and gastroscopy should not be performed to avoid gastrointestinal contents and gas interference imaging. Normal value The normal maximum diameter of the right lobe of the liver does not exceed 12 to 14 cm. The anteroposterior diameter of the right lobe of the liver was measured normally 8 to 10 cm. The normal diameter of the right lobe of the liver does not exceed 10 cm. The left half of the liver has a thickness and length of no more than 6 cm and a length of no more than 9 cm. The thickness and length of the midline of the clavicle in the right lobe of the liver are normal. When the liver is in a steady breathing, the ultrasound is often not detected under the costal margin; when the deep breathing is reached, the length can reach 0.5 to 1.5 cm below the costal margin; The degree of mobility is also large, and the length is significantly increased when deep breathing, and may even be 5 to 6 cm in comparison with smooth breathing. Liver size, shape, margin, envelope smoothing and continuity, uniformity of echo in liver parenchyma, distribution of hepatic vessels, bile ducts, direction, texture clarity; no abnormalities in liver activity, envelope and surrounding The organization is non-adhesive. There were no enlarged lymph nodes in the hilar and abdominal cavity; no ascites. The test was negative for normal. Clinical significance Abnormal result 1. Cirrhosis of the liver, portal vein high pressure collateral circulation. 2. Underarm sputum or abscess. 3. Intrahepatic fluid lesions, such as hepatic cysts, polycystic liver disease, liver hydatid disease and liver abscess formation period. 4. Fatty liver. 5. Primary hepatic or metastatic tumors. 6. Significant vascular abnormalities in the liver, such as congestion of the liver, abnormal portal vein disease, aneurysm. 7. Hepatic congenital anomalies. 8. Schistosomiasis liver disease. 9. Hepatic traumatic bleeding. Need to check the health checkup of the liver of the population or the clinically assisted diagnosis of liver disease. Precautions Taboo before inspection: Fasting before the upper abdomen examination (at least 8 hours), if necessary, venting, guiding, urinary bladder filling before pelvic organ examination, ultrasound examination can not be used for barium meal and gastroscopy on the day to avoid gastrointestinal contents, gas Interference imaging. Note when checking: When the right intercostal scan is performed to observe the structure of the liver at the top of the right iliac crest, the patient should be exhaled as much as possible, so that the squat can be raised as much as possible, so that the ultrasound beam can be effectively projected to the above area, so that the examiner has enough time to adjust the sound. Beam projection direction and observation, analysis of sonographic features. In the same way, in other parts of the liver, inhale as much as possible to make the diaphragm drop as much as possible and then hold the breath to avoid the ribs, rib arches and gastrointestinal gas shielding to get the best display. When measuring the blood flow spectrum of the blood vessel, temporarily hold the breath for 3 to 5 seconds, and acquire a stable spectrum during this time. Do not hold your breath for a long time. So as not to cause spectral errors. Inspection process Check position (1) supine position: for regular examination position. The patient is lying on his back, breathing smoothly, and both hands are placed behind the pillow. Mainly used to check the left lobe of the liver, the right anterior lobe and part of the right posterior lobe. (2) The patient in the left lateral position is placed in the 450-900 position on the left side, and the right arm is placed on the back of the head to facilitate observation of the right lobe of the liver, especially the observation of the right posterior lobe. (3) Semi-recumbent position, sitting position and standing position: suitable for patients with high liver position, used to understand liver activity to diagnose liver sag. (4) prone position: generally not used, only in the liver position is too high, the right lobe of the liver is significantly enlarged or need to be used in differential diagnosis with other diseases such as retroperitoneal mass. Inspection Method 1. Use regular inspection real-time B-type ultrasound system, convex array or linear array probe, frequency 2.5~5.0MHz. Color Doppler ultrasound is required to observe the hepatic vascular blood flow status. No special preparation is required before inspection. Liver cirrhosis and more abdominal gas can be checked after drinking 500~800ml. 2. The examinee often takes the supine position, and can also take the left and right lateral position or sitting position as needed. Breathing calmly and evenly, but when measuring the length and thickness of the slanting diameter of the hepatic rib and the left lobe, hold your breath after deep breathing. 3. Check the size and position of the liver, and observe the following 4 sets of sections. (1) Starting from the fifth rib space on the right side, measure the upper boundary of the liver, along the intercostal space from the midline of the right clavicle to the midline of the midline to the lower edge of the liver, showing the liver, but the trunk of the portal vein to the right trunk and branches of the portal vein. Long axis and inferior vena cava. (2) detecting the long axis of the right hepatic vein in the liver region from the right lower edge of the liver to the transverse diaphragm, measuring the maximum oblique diameter of the right lobe of the liver; the sagittal section or oblique section parallel to both sides of the midline of the abdomen, showing the caudate lobe, liver Segmental inferior vena cava; long axis of gallbladder, common bile duct. (3) The length and thickness of the left lobe of the liver were measured before the sagittal section of the sagittal section of the xiphoid; the probe was placed under the left costal margin, and the sound beam was oriented toward the left shoulder and the left rib, showing the left outer lobe and the left lobe. (4) The transverse or semi-transverse plane of the xiphoid process, the front and rear rotation of the probe shows the first hepatic portal, the portal vein and its left branch, the round ligament, the venous ligament, the three hepatic veins, the second hepatic portal and part of the inferior vena cava. When the liver and spleen were translocated, the left intercostal space was detected and compared with the right side. The position of the gallbladder, the portal vein, the common bile duct and the branching liver and the round ligament of the liver were confirmed, and the liver and spleen were confirmed. 4. Display hepatic vessels. The portal vein system is parallel to the hepatic artery, and the first hepatic portal enters the liver parenchyma, and its main branch runs in the liver; the three hepatic veins flow from the periphery of the liver to the second hepatic portal into the inferior vena cava. 5. Detect the direction, velocity and color flow of the infraorbital vena cava blood flow in the portal vein system, hepatic vein and hepatic segment. 6. Display the intrahepatic and extrahepatic bile duct system. The common bile duct is parallel to the portal vein. Before walking in the portal vein, the inner diameter is about 1/3 of the portal vein. 7. For abnormal lesions in the liver, the sound beam needs to be confirmed from three directions to eliminate artifact interference. It is also necessary to mark the lesion in the liver, adjacent blood vessels or tissues. 8. Detect the relationship between the liver and adjacent organs and surrounding tissues. Not suitable for the crowd No special people. Adverse reactions and risks No complications.

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