肝脏疾病超声诊断 Diagnosis of Liver Disease with Ultrasound Sonography

肝脏疾病超声诊断 肝脏弥漫性疾病 肝脏弥漫性疾病 Diffuse Liver Disease Diffuse Liver Disease 肝脏占位性疾病 Focal Abnormalies

正常肝脏声像图 大小、形态、包膜、边界 大小、形态、包膜、边界 size shape capsule boundary size shape capsule boundary 肝实质回声 liver parenchyma 肝实质回声 liver parenchyma echo pattern : isoechoic homogeneous 肝內管道系统 肝內管道系统 hepatic artery portal vein hepatic veins intrahepatic biliary 肝质地 肝质地

left lobe sagittal section left lobe sagittal section

right lobe sagittal oblique view

Port vein (color Doppler mode)

Port vein (color Doppler+spectrum)

Hepatic artery

Hepatic artery (color Doppler+spectrum)

Hepatic vein

Hepatic vein (color Doppler+spectrum)

Cystic lesion b simple hepatic cysts (congenital hepatic cysts) b Traumatic cysts b parasitic cysts b inflammatory cysts b polycystic disease b pseudo-cysts

Simple Hepatic Cysts Ultrasound findings b The cyst walls are thin with well-defined borders borders b anechoic in the cyst b distal posterior enhancement b Sometimes cysts contain fine linear internal septal. internal septal.

Hepatic Abscess Ultrasound findings b Round or ovoid shape with thick wall b Hypoechoic, complex, may be have a fluid level (with some debris along the posterior margin) (with some debris along the posterior margin) hyperechoic with dirty shasowing (if gas is present) hyperechoic with dirty shasowing (if gas is present) b posterior enhancement

Cavernous Hemangioma ultrasound findings ultrasound findings  round, oval, or lobulated shape with well- defined borders defined borders b hyperechoic, anechoic, mixed pattern b posterior enhancement

Hepatocellular Carcinoma ultrasoud findings ultrasoud findings b round, irregular shape b hypoechoic, hyperechoic, isoechoic b a halo surround the lesion b color Doppler signal was presented in the tumor or surround the tumor

Metastatic Disease ultrasoun findings shape round or oval number two or more than echoic pattern various color Doppler no flow inside

Cirrhosis Ultrasound findings the liver size: smaller the liver size: smaller nodularity of the liver edge nodularity of the liver edge parenchyma: coarsening, increased attenuation parenchyma: coarsening, increased attenuation portal hypertention portal hypertention the diameter of hepatic vein tiny and twist the diameter of hepatic vein tiny and twist severe : invisible severe : invisible hardness hardness

regenerating

HCC secondary cirrhosis

portal vein spectrum pattern flatten flatten

Portal hypertention Portal hypertention portosystemic venous collaterals portosystemic venous collaterals paraumbilical vein; coronary vein; paraumbilical vein; coronary vein; gastroesophageal vein; gastroesophageal vein; splenorenal-gastrorenal vein splenorenal-gastrorenal veinsplenomegalyascites

ascites

F atty Liver (fatty infiltration) F atty Liver (fatty infiltration) Ultrasound findings increased echogenicity with increased increased echogenicity with increased atenuation ( far field ) atenuation ( far field ) hepatic vessel unclare hepatic vessel unclare focal sparing focal sparing masslike hypoechoic masslike hypoechoic

F atty Liver (fatty infiltration) F atty Liver (fatty infiltration) Ultrasound findings increased echogenicity with increased increased echogenicity with increased atenuation ( far field ) atenuation ( far field ) hepatic vessel unclare hepatic vessel unclare focal sparing focal sparing masslike hypoechoic masslike hypoechoic