Liver Imaging Unisa presention

Benson Experience Precision Care Radiology

Team Members

  • Kevin M Williams: Ultrasound Modality Manager

  • Dr. S Knox: Managing Partner

  • Emma Godrik: Education Manager

Liver Imaging in Radiology

  • Options for Imaging: Explore different modalities available.

  • Ultrasound's Role: Assessment of liver conditions.

  • Benefits and Limitations of Ultrasound:

    • Non-invasive, cost-effective, and widely available.

    • Limited in certain diagnostic capabilities compared to CT and MRI.

  • Challenges in Ultrasound Use: Factors complicating effective imaging.

  • Sonographers' Role and Training: Changes in practice and necessary education for sonographers.

Anatomy and Functions of the Liver

  • Size and Weight: Approximately 1.2 to 1.5 kg in adults, increases with age.

  • Blood Flow: 10% of body's blood supply at one time; supplied by portal vein and hepatic arteries.

  • Key Functions:

    • Metabolism, digestion, immunity, and endocrine functions.

    • Unique ability to regenerate.

  • Size Variation: Changes based on age, sex, and body size.

Liver Anatomy & Functions

  • Hepatic Purification: Cleanses blood, metabolizes nutrients, produces bile.

  • Detoxification: Liver's role in managing toxins from digestion.

Liver Vasculature

  • Portal Vein:

    • Supplies 75% of blood, bringing deoxygenated nutrient-rich blood.

    • Continuous hepatopetal flow on Doppler ultrasound.

  • Hepatic Artery:

    • Supplies 25% of blood flow with oxygenated blood.

    • Follows hepatopetal direction.

Couinard Segments of the Liver

  • Nine Segments Identified:

    • Right lobe: Segments 5, 6, 7, 8.

    • Left lobe: Segments 4a, 4b, 2, 3.

    • Segment 1: Caudate lobe with its own blood supply.

    • Blood flow segmentation based on hepatic veins.

Imaging Modalities Overview

  • Different Imaging Perspectives:

    • Sonographers: Ultrasound imaging.

    • CT Radiographers: CT perspectives.

    • MR Techs: MRI insights.

    • Collaborative view needed among specialties.

Role of Radiography in Liver Imaging

  • Examples of Limitations: Calcified Hepatic Hydatid cyst detection is limited with imaging.

Liver Imaging with MRI

  • Medicare Criteria for MRI Orders:

    • Criteria include confirming extra-hepatic malignancy and negative CT imaging.

    • Special conditions requiring specific patient profiles for funding.

Hepatic Imaging Insights

  • Incidental Findings: "Incidentalomas" and benign liver lesion prevalence.

  • Ultrasound May Reveal:

    • Cirrhosis, Steatosis: Background parenchyma assessment.

    • Lesions: Identification of cystic versus solid masses.

Ultrasound Limitations

  • Registration of Enhancement Patterns: Other modalities required for detailed lesion analysis.

  • Cyst and Cell Comparison: Differentiation of solid lesions, vascularity, and echogenic characteristics.

CT Imaging Insights

  • Multiphase CT (IV Contrast): Different phases provide a comprehensive view of liver pathology.

  • Capabilities:

    • Enhancements, background parenchyma evaluation, identification of lesions.

    • Reliance on contrast for detailed imaging outcomes.

MRI Functionality in Imaging

  • In-depth analysis with Multiple Sequences: MRI utilizes several series for comprehensive imaging.

  • Background Parenchyma Evaluation: Critical for identifying cirrhosis and lesions.

Chronic Liver Disease Management

  • Impact of Chronic Liver Disease:

    • Progressive fibrosis, cirrhosis development leads to severe complications.

    • Regular screening and monitoring vital for managing health outcomes.

Diagnostic Procedures in Chronic Liver Conditions

  • Ultrasound's Role: Key in diagnosing and managing chronic liver diseases.

  • Liver Biopsy: Significant for staging but comes with risks and variability.

  • Elastography: Non-invasive method measuring liver stiffness and assessing fibrosis.

Liver Fibrosis and Its Implications

  • Importance: Early detection can lead to effective management and potential reversibility of conditions.

Benign Liver Lesions Assessment

  • Common Benign Conditions:

    • Haemangiomas: Most prevalent, generally asymptomatic.

    • Focal Nodular Hyperplasia: Requires advanced imaging for accurate diagnosis.

  • Abscess Diagnosis: Identification through ultrasound techniques.

Chronic Liver Disease and its Symptoms

  • Signs of Progressive Disease: Fatigue, jaundice, abdominal pain, risk of varices, and carcinoma development.

Sonographer Training and Role

  • Ultrasound Training Programs: Structured programs for radiologists and staff.

  • Role and Responsibilities: Critical input into diagnosis and treatment processes; continual education and teamwork emphasized.

Becoming a Sonographer

  • Pathway: Requires medical background and postgraduate qualifications with clinical training.

Ultrasound Overview

  • Benefits and Features: Non-invasive, cost-effective, and essential as a first-line assessment tool in various scenarios.

Conclusion

  • Contact Information: Kevin Williams, Ultrasound Modality Manager - kevin.williams@bensonradiology.com.au.