14. Ultrasonography of the liver
Fatty liver:
Increased echogenicity
Liver enlargement.
Not always uniform
Patchy distribution :specially in the right
lobe
Focal fat sparing: anterior to GB or PV
32. Focal liver lesions
Focal nodular hyperplasia
Second most common benign focal
lesion after haemangioma.
Well defined
More in the right lobe
May have a central scar
More in female 20 – 40 years.
homogenously isoechoic, but may
slightly hyper- or hypoechoic
44. Focal liver lesions
Klatskin Tumor - Hilar Cholangiocarcinoma
The most common site of biliary adenocarcinoma
These tumors are also known as Klatskin tumors.
Klatskin tumors have an aggressive biologic
behavior.
52. Diffuse Liver Disease
Schistosomal hepatic fibrosis: (Thickened portal
tracts):
Portal tracts appear in US as portal vein
radicles only. If the wall of these radicles are
thickened, we measure the portal tracts
(outer-outer diameter). If the diameter is
more than 3 mm in more than 3 tracts
“Periportal Thickening”.
73. CBD
CBD dilatation if more than 8 mm.
IHBR
Normally they are not seen.
When dilated as in obstructed Jaundice
“double barrel sign” (portal vein tributary
and intrahepatic bile radicle).