Liver Diagnosis 1999.6.1

Liver Diagnosis 1999.6.1

1. Hepatitis

In acute cases, there is edema in the liver region, reduced echogenicity within the liver, and relatively enhanced echogenicity of the portal vein wall, forming multiple small equal signs. In chronic cases, echogenicity either increases slightly or returns to normal, with overall diffuse enhancement of echogenic points or bands being characteristic of chronic liver disease. Ultrasound diagnosis of hepatitis is non-specific and must be combined with clinical findings to make an accurate diagnosis.

2. Fatty Liver

Due to fat deposition, echogenicity throughout the liver generally increases, with dark areas of reduced echogenicity commonly seen in the deeper parts of the liver, and reduced or unclear echogenicity of intrahepatic blood vessels—these are characteristics of fatty liver.

3. Cirrhosis

① The surface of the liver is uneven, with bright spots and bright patches inside, mainly in the anterior part of the liver, while the posterior part shows attenuated dark areas; ② The wall of the portal vein thickens, with increased inner diameter, and later the hepatic veins become open; ③ The spleen enlarges, with a thickness exceeding 4.0 cm; ④ Ascites. Patients with cirrhosis often have an enlarged caudate lobe and atrophy of the right lobe.

4. Portal Hypertension

① When the inner diameter of the portal vein exceeds 1.4 cm, there is a possibility of portal hypertension; ② Splenomegaly; ③ Ascites; ④ Establishment of collateral circulation, such as re-opening of the umbilical vein, dilation of the gastric coronary vein, and communication between the splenic and gastric veins.

5. Portal Obstruction

A strong echo mass or an isoechoic mass can be seen in the portal vein, and its location can be determined. The portal vein loses its normal shape, and the surrounding area becomes sponge-like with collateral branches—this is caused by the expansion of collateral circulation veins.

6. Budd-Chiari Syndrome

This is a change caused by obstruction of the hepatic vein or inferior vena cava. The proximal part of the hepatic vein or inferior vena cava narrows, while the distal part dilates, leading to ascites and enlargement of the caudate lobe.

7. Difference Between Liver Cysts and Liver Abscesses

The former are generally thin, while the latter are generally thick.