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

肝脏疾病超声诊断肝脏疾病超声诊断

肝脏弥漫性疾病肝脏弥漫性疾病 Diffuse Liver DiseaseDiffuse Liver Disease

肝脏占位性疾病肝脏占位性疾病FocalFocal AbnormaliesAbnormalies

正常肝脏声像图正常肝脏声像图 大小、形态、包膜、边界大小、形态、包膜、边界 size shapesize shape capsule boundary capsule boundary

肝实质回声 肝实质回声 liver parenchymaliver parenchymaecho patternecho pattern : : isoechoic homogeneousisoechoic homogeneous

肝內管道系统肝內管道系统hepatic artery portal vein hepatic veinshepatic artery portal vein hepatic veins

intrahepatic biliary intrahepatic biliary 肝质地肝质地

left lobeleft lobe sagittal sagittal sectionsection

right lobe right lobe sagittal oblique sagittal oblique view view

right loberight lobe sagittal oblique sagittal oblique viewview

Port vein (color Doppler Port vein (color Doppler mode)mode)

Port vein (color Port vein (color Doppler+spectrum)Doppler+spectrum)

Hepatic arteryHepatic artery

Hepatic arteryHepatic artery (color (color Doppler+spectrum)Doppler+spectrum)

Hepatic vein Hepatic vein

Hepatic vein Hepatic vein

Hepatic veinHepatic vein (color (color Doppler+spectrum)Doppler+spectrum)

Cystic lesionCystic lesion

simple hepatic cysts (congenital hepatic cysts) simple hepatic cysts (congenital hepatic cysts) Traumatic cysts Traumatic cysts parasitic cysts parasitic cysts inflammatory cystsinflammatory cysts polycystic diseasepolycystic disease pseudo-cystspseudo-cysts

Simple Hepatic CystsSimple Hepatic Cysts

Ultrasound findingsUltrasound findings The cyst walls are thin with well-defined The cyst walls are thin with well-defined

bordersborders anechoic in the cystanechoic in the cyst distal posterior enhancementdistal posterior enhancement Sometimes cysts contain fine linear Sometimes cysts contain fine linear

internal septal.internal septal.

Hepatic AbscessHepatic Abscess

Ultrasound findingsUltrasound findings

Round or ovoid shape with thick wallRound or ovoid shape with thick wall Hypoechoic , complex , may be have a fluid level 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) posterior enhancementposterior enhancement

Cavernous HemangiomaCavernous Hemangioma

ultrasound findings ultrasound findings

round , oval, or lobulated shape with well- round , oval, or lobulated shape with well-

defined bordersdefined borders hyperechoic, anechoic, mixed pattern hyperechoic, anechoic, mixed pattern

posterior enhancement posterior enhancement

Hepatocellular CarcinomaHepatocellular Carcinoma

ultrasoud findingsultrasoud findings round, irregular shape round, irregular shape

hypoechoic, hyperechoic, isoechoic hypoechoic, hyperechoic, isoechoic

a halo surround the lesion a halo surround the lesion

color Doppler signal was presented in the tumor or surround color Doppler signal was presented in the tumor or surround the tumor the tumor

Metastatic DiseaseMetastatic Disease

ultrasoun findingsultrasoun findings

shape round or oval shape round or oval

number two or more thannumber two or more than

echoic pattern various echoic pattern various

color Doppler no flow insidecolor Doppler no flow inside

CirrhosisCirrhosis

Ultrasound findingsUltrasound findings

the liver size: smallerthe liver size: smaller

nodularity of the liver edge nodularity of the liver edge

parenchyma: coarsening, increased attenuationparenchyma: coarsening, increased attenuation

portal hypertention portal hypertention

the diameter of hepatic vein tiny and twist the diameter of hepatic vein tiny and twist

severe : invisiblesevere : invisible

hardnesshardness

regeneratinregeneratingg

HCC secondary HCC secondary cirrhosiscirrhosis

portal vein spectrum portal vein spectrum pattern pattern

flattenflatten

Portal hypertentionPortal hypertention

portosystemic venous portosystemic venous collateralscollaterals

paraumbilical vein; coronary vein; paraumbilical vein; coronary vein;

gastroesophageal vein; gastroesophageal vein;

splenorenal-gastrorenal veinsplenorenal-gastrorenal vein

splenomegalysplenomegaly

ascitesascites

ascitesascites

FFatty Liver (fatty atty Liver (fatty infiltration)infiltration)

Ultrasound findingsUltrasound findings

increased echogenicity with increased echogenicity with increased increased

atenuation ( far field )atenuation ( far field )

hepatic vessel unclare hepatic vessel unclare

focal sparing focal sparing

masslike hypoechoicmasslike hypoechoic

FFatty Liver (fatty atty Liver (fatty infiltration)infiltration)

Ultrasound findingsUltrasound findings

increased echogenicity with increased echogenicity with increased increased

atenuation ( far field )atenuation ( far field )

hepatic vessel unclare hepatic vessel unclare

focal sparing focal sparing

masslike hypoechoicmasslike hypoechoic