liver

Normal Anatomy

• Largest solid organ.

• Right lobe, left lobe, caudate lobe (separate blood supply).

• Portal triad: hepatic artery + portal vein + bile duct.

Normal Measurements

• Liver length: 13–15 cm

• MPV: <13 mm

• CBD (in liver chapter related pts): <6 mm (<10 mm post-cholecystectomy)

Normal Echogenicity

• Liver > kidney

• Liver < pancreas

Key Liver Pathology

Fatty Liver (Steatosis)

• ↑ echogenicity (“bright”)

• Poor penetration

• Vessels obscured

Hepatitis

• Acute: hypoechoic, “starry sky”

• Chronic: coarse, echogenic, small liver

Cirrhosis

• Nodular surface

• Coarse texture

• Caudate enlargement

• Portal HTN signs

Hepatic Cysts

-Anechoic, thin wall, posterior enhancement.

Hemangioma

• Most common benign liver tumor

• Hyperechoic, homogeneous, well-defined

HCC (Hepato cellular carcinoma)

• Risk: cirrhosis

• Heterogeneous, vascular.

Metastases

• Most common malignant liver lesion

• Appearance variable:
  
  

  • Hypoechoic (breast/lung)

  • Hyperechoic (GI)

  • “Target” or “bull’s-eye”