The liver is a parenchymal organ and the largest gland in the body. Diagnosis of liver diseases requires the use of both laboratory and instrumental methods of examination. One of the most informative methods is ultrasound of the liver. The norm, decoding of indicators are the subject of this article.
Structure and structure of the liver
The liver is the largest laboratory of the human body, where a large number of substances are processed and synthesized. It consists of 4 parts. The two largest - right and left, are the largest and are well visualized on ultrasound. The other two - square and caudate, are much smaller and do not have significant diagnostic value during examination. Externally, the liver is covered with a Glisson capsule, which reacts with an increase in the size of the gland.
The functional and structural unit is the hepatic lobule, which consists of several hepatocytes, small veins, arteries and excretory bile duct. The hepatocyte is a specialized cell in which synthetic andmetabolic processes.
The vascular system of the liver
The blood supply to the liver is carried out by the hepatic arteries. The outflow of blood is provided by the portal vein, which is a large reservoir that collects blood from the unpaired organs of the abdominal cavity. The liver filters this blood mass and transfers it to the inferior vena cava. To the greatest extent, the liver synthesizes bile, which flows through small bile capillaries into the right and left common hepatic ducts, and then through the common bile duct into the duodenum. To fully explore and study the structure of these formations allows ultrasound of the liver. The norm, decoding of the examination allow for differential diagnosis with other diseases of the gland and surrounding organs.
Liver Functions
One of the most important is the detoxification function. The unique structure of the hepatic lobule and the structure of the venous system, which forms sinusoids, ensures the retention and neutralization of metabolic products and incompletely oxidized compounds in the gland parenchyma, followed by the removal of the latter. The excretory role of the liver is in the synthesis of bile, which is a solution of bile and fatty acids and some trace elements. The synthetic function of the gland is the formation of almost all protein fractions of the blood and some specific substances (lipoproteins, blood coagulation factors, enzymes).
Bile has a detergent function and stimulates intestinal peristalsis. Digestive rolealso provided by bile, which promotes the emulsification of fats and improves the digestion of the latter by pancreatic lipase. The protective role of the largest gland of the body involves the synthesis of protective immunoglobulins and some components of the complement system. In the fetus and newborns, the liver plays the role of hematopoiesis. The size of the liver depends on the correct functioning and functioning of the organ. The norm in an adult is a relatively constant value and may differ in the range of 1-4 cm.
The essence of ultrasound examination
Ultrasound is a widely available, relatively cheap and painless method of examining internal organs.
Ultrasound has the ability to reflect from the internal organs and thus change the length and frequency of the wave. These changes are captured by the sensor of the ultrasound machine and sent to the control unit, where the image is processed and formed on the monitor. In this case, the sensor acts simultaneously as a generator of ultrasonic waves.
One of the most accessible organs for examination is the liver. The dimensions of the ultrasound probe and its resolution make it possible to examine the organ from different angles and study the homogeneity of its structure. In addition, the largest gland of the body has in its composition heterogeneous structures (vessels, bile ducts).
When an ultrasound scan of the liver is done
First of all, people who are undergoing a medical examination should visit the ultrasound examination room. This technique allows you to see some dangerous diseases at the initial stages of development andprovide appropriate treatment. Patients diagnosed by a doctor as "liver abscess" or "viral hepatitis" are obligatory clients of the ultrasound room. Traumatic injury to the abdominal organs, suspicion of neoplasms, or changes in laboratory tests (especially liver tests) are grounds for an ultrasound examination of the liver.
Gynecologist sometimes requires ultrasound to select the optimal method of hormonal contraception and in almost all malignant neoplasms of the female reproductive system. Patients suffering from alcoholism or already having cirrhosis of the liver should periodically examine this organ on an ultrasound machine. If you periodically notice cutting pain in the right hypochondrium and lack of appetite, you should also do an ultrasound of the liver. The norm, deciphering the result in the vast majority of cases, allows you to immediately make the correct diagnosis.
How to prepare for a liver ultrasound
The preparatory stage is an important point before the examination. It aims to create conditions for better visualization of the abdominal organs, including the liver. The patient must come to the examination on an empty stomach, and the last meal should be at least 8 hours before the examination. It is not recommended to consume foods that cause the formation of gases in the intestines (dairy and legumes) a day or two before ultrasound diagnostics. In addition, if a person has such a tendency, then he should take 3-4 tablets of black coal in the evening before the examination. The doctor may alsorecommend one or two cleansing enemas.
Liver ultrasound: indicators
An ultrasound doctor applies a special gel to the skin of the abdomen before the examination, which improves the contact of the sensor with the skin and ensures the formation of an optimal picture.
First of all, structure is evaluated. It is normally homogeneous. The edge of the liver should be even. After that, they begin to measure the size of the right and left lobes of the gland. For them, measure the thickness and sagittal size. Normally, for the right lobe, the thickness should be 11.2–12.6 cm, and the sagittal size should be up to 15 cm. The left lobe is smaller, so its thickness under normal conditions averages 7 cm, and the sagittal distance is up to 10 cm. An ultrasound machine can easily determine the overall size of the liver. The norm in an adult ranges from 14 to 18 cm in length and 20–23 cm in width.
Next, the parenchyma of the gland is analyzed for the presence of nodes, seals and calcifications, which form changes in the echo signal. By strengthening or weakening the ultrasound wave, the doctor can recognize a liquid or solid formation. Sometimes a shadow may form in the middle of the fluid formation, indicating a parasitic cyst.
Arteries, veins, and bile ducts are heterogeneous structures. The transverse size of the portal vein should not exceed 13 mm, and the inferior vena cava has a diameter of 10 to 15 mm. The hepatic veins, which empty into the vena cava, have a diameter of 6 to 10 millimeters. The hepatic artery is evaluated at the hilum of the liver, where its thickness is 4 to 7 mm. The common bile duct drains bile. Normally, its diameter should be from 6 to 8 millimeters.
Contraindications for examination
Ultrasound diagnostics in adults has no contraindications. If the patient is not prepared or did not properly perform the preparation for the examination, his appointment in the ultrasound room should be rescheduled. This will allow you to perform a better ultrasound of the liver. The norm, deciphering the result allows you to establish the correct diagnosis and prescribe the appropriate treatment.
Estimated price
If you are periodically worried about pain in the right hypochondrium, nausea, a feeling of bitterness in the mouth, then an ultrasound of the liver should be performed. The price compared to other instrumental methods is affordable and ranges from 700 to 1400 rubles.
