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Ultrasound of healthy abdominal organs. Abdominal hernias on ultrasound

Abdominal ultrasound is a common diagnostic procedure. Ultrasound abdominal cavity examination is carried out both to study diseases of certain organs, and during a preventive examination. Due to anatomical proximity and the performance of similar functions, a disease of one organ can affect neighboring ones. To correctly assess the condition of the organs, the doctor must have a good knowledge of the anatomy of the abdominal organs, their sizes and features. For all organs, their anatomical landmarks and usual localization are described. However, each person is unique, so certain average organ sizes are used.

Anatomy of the abdominal organs. Ultrasound scanning of the abdominal organs

The abdominal cavity is the space located between the diaphragm and the pelvic cavity. The abdominal cavity is lined with a membrane - the peritoneum, which serves as additional protection for the abdominal organs. It separates the so-called retroperitoneal space.

The abdominal cavity contains the following organs:

• liver and gall bladder;
• spleen;
• small intestine;
• large intestine;
• appendix.

The retroperitoneal space contains the kidneys, pancreas, nerve plexuses, aorta, inferior vena cava, lymph nodes and vessels. All organs of the retroperitoneal space are surrounded by fatty tissue. During ultrasound, the organs of the abdominal cavity and retroperitoneum are examined together, since the peritoneum is not visible on ultrasound.

Scanning of the abdominal organs is carried out at different positions of the ultrasound sensor, but always in at least two planes - longitudinal and transverse. When clarifying some formations, oblique, intercostal and other projections are used.

When scanning the right upper part of the abdominal cavity on the screen of an ultrasound machine, you can examine the liver, gall bladder, head of the pancreas, and duodenum. Vessels here include the portal vein, hepatic artery, aorta and inferior vena cava. When scanning the middle upper part of the stomach, the stomach, pancreas, duodenum, aorta and its main branches are examined. The spleen is examined during a scan of the left upper abdomen.

Ultrasound of the abdominal cavity in women and men

There are no significant differences in performing abdominal ultrasound in men and women, despite the fact that actual differences in the structure of the abdominal cavity do exist. The anatomical differences are that in women the peritoneal cavity has communication with the external environment through the ovaries and fallopian tubes. In men, the peritoneal cavity is closed.

The listed differences are important when examining the pelvic organs, since the reproductive system in men and women is structured differently. The abdominal organs are located equally and are approximately equal in size in both sexes. Therefore, the method of ultrasound examination of the abdominal organs is the same for men and women.

Ultrasound of the abdominal cavity in children ( newborns, children under one year of age)

Ultrasound is a fast, affordable and safe method for examining the abdominal cavity in children. Ultrasound does not cause them pain or discomfort, so it can be performed from a very young age. For newborns, an abdominal ultrasound is performed in the maternity hospital. Ultrasound assessment of organs is carried out taking into account existing age standards.

In newborns, the abdominal organs have the following average sizes:

• thickness of the right lobe of the liver – 50 mm;
• gallbladder length – 20 mm;
• pancreas thickness – 7 mm;
• spleen length – 40 mm.

During the first year of life, children undergo abdominal ultrasound according to certain indications. Ultrasound can detect abnormalities in the development of internal organs. If a child is underweight, has poor appetite, or frequently regurgitates, then it is recommended to conduct an ultrasound of the abdominal organs in order to detect the cause of the baby’s poor nutrition. At the same time, the research methodology for children does not differ from that for adults.

For older children, the indications for ultrasound examination are the same as for adults. As the child grows, the ultrasound characteristics and organ sizes must correspond to age standards. Ultrasound examinations of children are best performed in pediatric institutions that specialize in childhood diseases.

How is an abdominal ultrasound read? What do the colors mean on an abdominal ultrasound?

During an ultrasound examination, an image consisting of shades of varying brightness is obtained on the monitor screen. The brightness indicator of these structures is called echogenicity. It corresponds to the number of ultrasonic waves reflected from anatomical structures. The number of reflected waves depends on the density of the organ being examined.

When scanning in the most common B-mode, echogenicity is described as shades of gray. The better the equipment, the more shades of gray, and therefore the more echogenicity options that can be described during the study. In practice, when describing structures and drawing up conclusions, five echogenicity options are used. This allows us to greatly simplify the description of ultrasound examination. The acoustic density of the liver was taken as the average echogenicity value.

Variants of echogenicity of abdominal formations on ultrasound

Characteristics of acoustic density on ultrasound	Color Matching	Organs and formations of the abdominal cavity
Anechoicity		Any accumulation of fluid in the abdominal cavity. The lumen of blood vessels, stomach, intestines, gall bladder.
Hypoechogenicity	Dark gray	Spleen, lymph nodes.
Average echogenicity		Liver, pancreas.
Increased echogenicity	Light gray	Wall of blood vessels, hollow organs. Spleen capsule. Abdominal adhesions.
Hyperechogenicity	Bright white	Gallbladder stones, pancreatic calcifications, foreign bodies.

Many formations, especially pathological ones, do not have a uniform echogenicity. In this case, it is described as mixed. Mixed echogenicity on ultrasound is consistent with malignant tumors. This is explained by the fact that various processes are observed in them - the formation of cysts, proliferation of connective tissue, necrosis and calcification.

Ultrasound of soft tissues of the abdomen

Ultrasound of the soft tissues of the abdomen is performed separately from the examination of the internal organs of the abdominal wall. This study aims to detect hernias, fluid accumulations, and tumors in the anterior abdominal wall. Since the abdominal wall is thin, soft tissue examination is carried out at a shallow depth using high-frequency sensors ( 10 MHz). The exception is for overweight patients.

The anterior abdominal wall consists of two rectus abdominis muscles, separated at the center by a line alba. The lateral part of the abdominal wall includes three layers of muscles separated by membranes called fascia. The muscles are covered by a layer of subcutaneous fat cells, dermis and epidermis.

On ultrasound, muscles are less echogenic than the surrounding membranes, but when hernias, abscesses or tumors appear, unusual areas between the layers of muscle may appear. Depending on the content, such formations can be either anechoic or have increased echogenicity ( in case of tumor). During the examination of soft tissues, changes in pathological formations during breathing are of greater diagnostic importance ( Valsalva maneuver) and when changing body position.

Hernias of the anterior abdominal wall on ultrasound

Hernias of the anterior abdominal wall are the release of abdominal contents through a formed pathological hole in the abdominal wall. The places where hernias form are places where the muscular frame of the abdominal wall is not strong enough or is weakened due to weight loss or previous surgeries. In this case, the structures contained in the hernial sac are enveloped in peritoneum.

Hernias of the anterior abdominal wall are most often located in the following places:

• along the midline in the upper third of the abdomen ( hernia of the white line);
• near the umbilical ring;
• in the anterolateral part of the abdomen ( Spigelian line hernia);
• at the site of postoperative sutures.

The diagnosis of a hernia is usually made after a clinical examination. Ultrasound helps confirm the diagnosis of hernia and detect them in the absence of skin protrusion. Ultrasound clearly shows the hernial orifice, contents and size of the hernial sac. The most dangerous complication of a hernia is its strangulation. A non-strangulated hernia increases in size when coughing or taking a deep breath. This occurs due to increased intra-abdominal pressure.

Hernias are usually operated on to avoid enlargement of the hernial sac and complications in the future. In addition, they cause great inconvenience to the patient. Simultaneously with the reduction of the hernia, the abdominal wall is strengthened to avoid recurrence ( repetitions) her education. In children, the formation of peri-umbilical hernias can be explained by age-related weakness of the abdominal wall. Reduction of hernias, use of tight bandages and strengthening of the muscular frame leads to self-healing of hernias in children.

Ultrasound of the liver is normal. Ultrasound diagnosis of liver diseases

Ultrasound examination of the liver and biliary tract is performed for most diseases of these organs. Ultrasound of the liver is carried out first among all methods of radiological diagnostics, since this research method provides almost all the necessary information without the risk of harming the patient. X-ray methods are used only for strict indications.

Ultrasound of the liver, gallbladder and biliary tract is performed in the presence of the following symptoms:

• pain in the right hypochondrium;
• yellowness of the skin;

• unjustified increase in body temperature;
• stool disorders.

Using the ultrasound method, you can diagnose most liver diseases, such as acute or chronic hepatitis, liver tumors, cirrhosis. Sometimes, to clarify the diagnosis, additional methods of examining the liver are used. These include computed tomography ( CT) or magnetic resonance imaging ( MRI), diagnostic surgery.

Ultrasound of the liver is normal. Anatomy and signs of an ultrasound picture of the liver

The liver is a vital organ that performs a large number of different functions. The most important of them are the neutralization of various toxins, the synthesis of blood proteins and glucose, the production of bile, and hematopoiesis in the fetus. The liver is located in the right hypochondrium and consists of the left and right lobes, which are divided into relatively independent segments. The functional unit of the liver is the hepatic lobule. The blood supply and outflow of bile occurs in the area of ​​the porta hepatis, where the so-called hepatic triad is located.

In the area of ​​the porta hepatis there are three anatomical formations with the following normal dimensions:

• portal vein, with a diameter of 0.9 to 1.4 cm;
• hepatic artery having a diameter of 0.5 cm;
• common bile duct, the diameter of which is 0.7 cm.

An ultrasound scan of the liver is performed in the upper right part of the abdominal wall. Scanning is carried out in the sagittal, transverse and oblique planes. The upper edge of the liver is located behind the ribs, so the sensor must be placed in the intercostal spaces. The normal liver appears as a homogeneous echogenic structure because the entire liver parenchyma is composed of hepatic lobules. The echogenicity of the liver is average; it is with its density that all other abdominal organs are compared. In a homogeneous picture of the liver, there are also areas of hypoechogenicity corresponding to the portal vein and the venous bed of the liver. As you know, liver veins have a larger diameter than arteries, so they are better visible on ultrasound. During the Valsalva maneuver, the hepatic veins dilate. The Valsalva maneuver involves trying to forcefully exhale with your mouth and nose closed.

Ultrasound should also distinguish between the quadrate and caudate lobes of the liver, which are smaller than the left and right lobes. The caudate and quadrate lobes are located anterior and posterior to the porta hepatis. In cross section, the caudate lobe should be less than 2/3 of the right lobe of the liver. The caudate and quadrate lobes have moderate echogenicity but can be mistaken for tumors. The hilum of the liver is anechoic in the area of ​​the lumen of the vessels, since the liquid in their lumen completely absorbs ultrasonic vibrations.
To study the porta hepatis, the patient lies on his left side while the transducer is positioned in the transverse plane.

Liver sizes in adults and children are normal

The size of the liver is of great importance in the diagnosis of various diseases. A clinical examination of the patient necessarily includes determining its boundaries and size by palpation. However, with the help of ultrasound, the size of the liver is determined much more accurately. Enlargement of the liver, as well as its decrease, are signs of disease. However, when assessing the results, one should take into account large individual differences in liver size, which depend on hereditary factors and the patient’s body composition.

The liver has an irregular shape, so it is measured in several places - along the midline of the body and along the midclavicular line. The midline of the body is the axis of symmetry of the body. The midclavicular line is parallel to it, but passes through the middle of the clavicle. Length ( longitudinal size of the liver) is determined from the highest point of the dome of the diaphragm to the lower edge of the liver.

Doctors use the following average liver values ​​that correspond to normal:

• longitudinal size along the midclavicular line - 10.5 cm;
• longitudinal size along the midline of the body – 8.3 cm;
• anteroposterior size along the midclavicular line - 8.1 cm;
• anteroposterior size along the midline – 5.7 cm.

Due to anatomical differences, a deviation of the given values ​​by 1.5 centimeters is allowed, both down and up. In children, the liver on ultrasound has the same signs as in adults, but is usually better visible due to its smaller size and thinner layer of fatty tissue.

Longitudinal size of the liver of children along the midclavicular line depending on age

Hepatomegaly on liver ultrasound

Hepatomegaly is a condition in which the liver is enlarged. On ultrasound, a sign of hepatomegaly is the determination of its longitudinal size along the midclavicular line of more than 12 centimeters. Hepatomegaly occurs in a large number of diseases and can be caused by a large number of reasons.

Hepatomegaly is observed in the following diseases:

• Acute hepatitis. Typically, acute hepatitis is also characterized by heterogeneity of the parenchyma, along with liver enlargement. In addition, in the presence of jaundice, ultrasound can detect the possible presence of obstruction ( blockages) biliary tract.
• Chronic hepatitis. Impaired bile outflow as a result of chronic inflammatory processes leads to intoxication and death of liver cells. In this case, the homogeneous pattern of echogenicity of the liver is disrupted, since connective tissue is found in it.
• Cirrhosis. This degenerative process leads to almost complete replacement of liver tissue with connective tissue, which is why the liver practically does not perform its function. Initially, the liver is enlarged in size, but subsequently it decreases, becoming about 7 cm in length at the midclavicular line.
• Fatty hepatosis. This liver disease is accompanied by the accumulation of fat granules in the liver cells. It is caused by poor diet, consumption of too fatty foods, and alcohol. On ultrasound, heterogeneity of the liver parenchyma appears.
• Liver tumors. They are very diverse, so to clarify the diagnosis, a piece of tumor tissue is often taken and examined under a microscope.
• Heart failure. In this case, the increase in liver size is caused by overcrowding of the venous bed. In this case, the homogeneity of the parenchyma on ultrasound is preserved, but the expansion of the portal vein is determined.

Thus, to establish the exact causes of hepatomegaly, it is necessary to have complete information about the patient. Ultrasound of the liver helps to exclude some diseases, but for proper treatment, a full analysis of all diagnostic data is needed.

Increased and decreased echogenicity of the liver on ultrasound. Acute and chronic hepatitis on ultrasound

Normally, the echogenicity of the liver is homogeneous. This allows us to consider it as a standard and compare it with the density of the structures of other abdominal organs. A change in the echogenicity of the liver indicates changes in its cellular structure. This sign is of greatest importance in identifying liver diseases using ultrasound.

Diffuse changes in liver echogenicity are observed in the following diseases:

• acute and chronic hepatitis;
• cirrhosis;
• multiple abscesses;
• tumor metastases in the liver.

Acute hepatitis is a viral disease that occurs like a food infection. In acute hepatitis, intoxication of the body is observed, in some cases jaundice, fever, and nausea. Acute hepatitis ends with complete recovery of the patient, but in some cases it becomes chronic. On ultrasound, characteristic signs of acute hepatitis are an enlargement of the liver and spleen, a slight increase in the echogenicity of the hepatic parenchyma. The lymph nodes at the porta hepatis are enlarged. The gallbladder is empty because the liver temporarily reduces bile production, and has thickened walls due to inflammatory swelling.

Chronic hepatitis is caused by a blood-borne viral infection. The long course of chronic hepatitis is asymptomatic, but in most cases leads to cirrhosis or the formation of malignant liver tumors. The roughness of the liver pattern on ultrasound depends on the duration of chronic hepatitis and the presence of exacerbations. Chronic hepatitis is characterized by a slight expansion of the portal vein ( more than 15 mm in diameter) and a pronounced lobular pattern of the hepatic parenchyma. It is explained by the compaction of the connective tissue located between the lobules of the liver. In a healthy liver, the connective tissue is very thin and is not visible on ultrasound.

Cirrhosis of the liver on ultrasound

Liver cirrhosis is a chronic disease that results in the replacement of liver parenchyma with fibrous tissue. This occurs as a result of various factors, but always leads to the same outcome - complete liver failure. To prevent liver cirrhosis, liver disease must be treated at an earlier stage.

Signs of liver cirrhosis on ultrasound are:

• spotted parenchyma structure;
• increased echogenicity of the parenchyma;
• liver capsule defects ( intermittency);
• lobulation of parenchyma;
• hepatomegaly, and in the late stage – a decrease in liver size;
• dilation of the hepatic veins and inferior vena cava;
• no change in the lumen of the hepatic veins during breathing;
• enlarged spleen;
• ascites ( accumulation of free fluid in the abdominal cavity).

Liver cirrhosis is an irreversible condition and requires liver transplantation to treat it. To prolong the life of a patient with cirrhosis, diet and medications are used to protect liver cells from destruction.

Dilatation of the portal vein. Portal hypertension. Ascites ( accumulation of fluid in the abdominal cavity) on ultrasound

Blood enters the liver through two vessels - the portal ( gate) vein and hepatic artery. The portal vein is a vessel into which venous blood flows from all abdominal organs. After being filtered in the liver, venous blood enters the inferior vena cava through the hepatic veins and goes to the heart.

For liver diseases ( for example, with chronic hepatitis) liver cells die and are replaced by connective tissue. This leads to obstruction of blood flow in the liver, causing the portal vein to increase pressure and dilate. This phenomenon is called portal hypertension. Without eliminating the factor that caused the death of hepatocytes ( liver cells) this condition cannot be treated.

Signs of portal ( gate) hypertension on liver ultrasound are:

• expansion of the portal vein more than 11 mm inside the liver and more than 15 mm outside the liver;
• absence of variation in the lumen of the portal vein during breathing and the Valsalva maneuver;
• dilatation and rigidity of the veins flowing into the portal vein ( gastric, mesenteric);
• blood flow velocity in the portal vein on duplex ultrasound with color Doppler mapping ( CDE) decreases to 10 cm/s ( Normally it is 18 – 20 cm/s).

In severe cases, portal hypertension causes very unpleasant symptoms. The first of these is the redirection of venous blood flow. Venous blood begins to circulate not through the liver, but through superficial veins located in the skin. Blue swollen veins look like a “jellyfish head” when examining the abdomen. Dilatation of the veins of the esophagus threatens their rupture and internal bleeding. The most difficult complication of portal hypertension is ascites.

Ascites is the release of free fluid from the venous bloodstream into the abdominal cavity. Its volume can be up to 25 liters. On ultrasound, ascites appears as a large anechoic area with rare echogenic inclusions. This fluid can become infected spontaneously, but even its removal does not bring relief because it forms again. Treatment requires eliminating the cause of liver damage or performing a liver transplant.

Local changes in liver tissue on ultrasound. Liver tumors and cysts on ultrasound

An ultrasound of the liver can reveal local changes of varying echogenicity. They can come in various shapes and sizes. To confidently differentiate between them, you need to have data from a general blood test, and also, if necessary, conduct additional research.

Local changes in the liver on ultrasound can be explained by the following structures:

• Liver cysts. These are cavities in the liver tissue that are dark-colored anechoic structures. They can be congenital or acquired as a result of inflammatory or infectious processes.
• Renal artery aneurysm. It is a congenital dilatation of the renal artery. On ultrasound it appears as an anechoic area.
• Liver abscess. Accumulation of pus in the liver tissue, which may have a heterogeneous structure, from hypoechoic to hyperechoic.
• Local fatty infiltration ( hepatosis). It represents areas where the liver tissue has areas of fatty inclusions. Most often they are located at the porta hepatis and have a hypoechoic color on ultrasound.
• Liver tumors ( carcinoma, adenoma, hemangioma and others). Liver tumors have different characteristics on ultrasound. They can be either hypoechoic or hyperechoic. Malignant tumors often have irregular borders and can invade the hilum of the liver or neighboring organs.
• Stones and calcifications. They can occur both inside the liver and in the hepatic excretory duct. They appear as hyperechoic formations and leave behind an acoustic shadow. An acoustic shadow is a place where ultrasonic waves do not penetrate due to the high density of the stone itself.

To differentiate ( differences) of the listed formations may require additional research. For tumors, only tissue biopsy and microscopy can be considered a reliable diagnostic method. Despite this, computed tomography and magnetic resonance imaging are more informative methods in diagnosing liver tumors.

Ultrasound of the gallbladder and bile ducts

The gallbladder is considered part of the liver due to its anatomical proximity and shared function. The gallbladder helps the liver perform its digestive function. However, gallbladder diseases are classified as a separate group and are treated independently. It must be borne in mind that gallbladder diseases very often lead to various liver disorders. Inflammation from the gallbladder easily spreads to the liver, since they are suddenly adjacent to each other. The presence of stones in the gall bladder leads to the fact that liver cells are affected by bile components.

Ultrasound can diagnose many gallbladder diseases. The most common among them are cholecystitis, cholelithiasis, and polyps. Ultrasound is the main method for diagnosing gallbladder conditions due to its high availability and information content. Dyskinesia ( defecation disorders) of the gallbladder can be diagnosed using food-stress ultrasound.

Ultrasound of a healthy gallbladder

The gallbladder is located under the liver, on its lower surface. This is a hollow organ that is a collector of bile. The liver produces bile almost constantly, but it enters the gastrointestinal tract only when necessary by contracting the muscular wall of the gallbladder. It occurs during eating. All the time between meals, bile accumulates in the gallbladder.

An ultrasound of the gallbladder is performed, like an ultrasound of the liver, with the patient positioned on his back or left side. Examination of the gallbladder must be carried out very carefully so as not to miss the presence of gallstones in the bladder. The gallbladder is a hollow organ, so on ultrasound it is anechoic, that is, dark black in color. However, the wall of the gallbladder, consisting of muscles and connective tissue, appears on ultrasound as a clear hyperechoic rim of a light-bright color. The gallbladder is pear-shaped in transverse sections and oval in longitudinal sections.

Ultrasound of the bile ducts and common bile duct is normal

The bile ducts form a specific closed system. The right and left hepatic ducts emerge from the right and left lobes of the liver. They unite into the common hepatic duct. A tortuous cystic duct approaches it. The hepatic and cystic ducts unite to form the common bile duct. Outside of meals, bile flows from the hepatic duct into the gallbladder, and from there into the gastrointestinal tract.

The hepatic ducts are visualized upon careful examination as thin anechoic stripes. The common bile duct is measured in a longitudinal plane anterior to the right branch of the inferior vena cava. Its normal diameter is up to 4 mm. With age, the diameter of the duct increases to 10 mm. When the gallbladder is removed, the lumen of the duct also becomes wider.

The size of the gallbladder in adults and children is normal

Changes in the size of the gallbladder are sensitive to disruption of its function. Therefore, during an ultrasound examination, doctors must determine its size. They are dependent on food intake, so it is very important to tell your doctor about the time of your last meal. The length of the gallbladder in adults is from 10 to 12 cm, and the width is 4 to 5 centimeters. The thickness of the gallbladder wall is determined in the area adjacent to the liver. The average wall thickness should be no more than 3 mm. If it is thick, this indicates inflammation or pathological formation.

In children, the size of the gallbladder depends on age. The research method and ultrasound image of the gallbladder in children do not differ from the image of the gallbladder on ultrasound in adults. However, the last meal before the study in young children can be taken not 6 hours before, as in adults, but 3 to 4 hours before.

Average length of the gallbladder in children

Ultrasound of the gallbladder with food load ( trial breakfast)

Ultrasound of the gallbladder is the only method to assess its condition without interfering with the internal environment of the body. Using ultrasound, you can assess the functional state of the organ. It consists in the ability of the gallbladder wall to contract after eating, releasing bile into the small intestine. Sometimes problems with the gallbladder are detected only after eating, but are normal at rest. To assess the functional state of the organ, a special ultrasound examination method is used - ultrasound of the gallbladder with food load.

First, a routine examination of the gallbladder and biliary tract is performed. It is assumed that the patient followed a proper diet and ate his last meal 8 hours before the study. The doctor measures the dimensions of the organ, which should be 12 cm in length and 2–4 cm in width. The wall thickness is up to 3 mm.
The study is carried out in at least two positions - lying on your back and on your side.

After this, the patient eats two eggs, kefir or sour cream with high fat content. This is done so that the gallbladder contracts and secretes bile, which is known to occur in response to eating foods containing fats ( including cholesterol). Ultrasound is repeated 10, 25 and 50 minutes after eating. During each study, the size of the organ is measured. Normally, the gallbladder should shrink by 60 - 70% after 50 minutes, that is, its length should be about 5.5 cm.

During an ultrasound of the gallbladder with a food load, the following parameters are assessed:

• rate of bile excretion;
• the degree of contraction of the gallbladder walls;
• the tone of the sphincter of Oddi, located between the bile duct and the duodenum.

Ultrasound of the gallbladder with a food load makes it possible to diagnose biliary dyskinesia. This allows timely treatment to prevent diseases of the gallbladder, liver and the entire gastrointestinal tract.

Biliary dyskinesia ( JVP)

Biliary dyskinesia is a disorder of biliary motility. Normally, bile should be released with any meal. If bile is not secreted, then other organs of the gastrointestinal tract suffer because of this, and the body does not absorb all the necessary elements from food, primarily essential fatty acids. JVP is accompanied by pain in the right hypochondrium associated with eating, periodic nausea, and bitterness in the mouth.

The following factors are to blame for the development of ADHD:

• various gallbladder diseases ( for example, cholecystitis);
• violation of the nervous regulation of bile secretion.

An ultrasound usually reveals symptoms of the gallbladder disease that causes it. Most often, stones are found in the gallbladder in the form of hyperechoic structures. In the absence of disease symptoms, an ultrasound with a food load is performed and the vegetative nature of dyskinesia is established. Neurogenic dyskinesia of the biliary tract can lead to many diseases, such as cholecystitis, cholelithiasis. For successful treatment, it is necessary to establish the cause of dyskinesia and act on it. Typically, a special diet and choleretic drugs are used to treat GIVP.

Gallstone disease ( cholelithiasis) on abdominal ultrasound

Gallstone disease is a disease in which various types of stones form in the gallbladder. Stones may consist of cholesterol, bilirubin, calcium salts. The disease is very common, occurring in 10% of the population, and in women several times more often than in men. Dietary habits, namely fatty and protein-rich foods, play an important role in the formation of gallstones.

The formation of gallstones over time may not cause any symptoms, but over time it increases the risk of developing inflammatory gallbladder disease. If a stone enters the biliary tract, it leads to disruption of the outflow of bile, severe pain, obstructive jaundice and requires surgical treatment.

On ultrasound, stones can look different. This largely depends on their size and composition. The advantage of ultrasound examination is that with the help of ultrasound it is possible to detect incipient stones in the form of sediment and take preventive measures.

Ultrasound reveals the following signs of gallstone disease:

• Precipitate of cholesterol and bilirubin crystals. It is an echogenic homogeneous mass that shifts when the patient’s body position changes. It is distinguished from formed stones by the absence of an acoustic shadow.
• Sand. It is an accumulation of granular echoes, more echogenic than sediment. It can also move relative to the wall of the gallbladder during body movement.
• Single stone. It is a dense hyperechoic formation. It leaves behind an acoustic shadow - a completely black area where ultrasonic waves do not penetrate.
• "Stone" gallbladder. As gallstone disease progresses, the entire gallbladder becomes filled with stones. Visualization of individual stones is difficult, since collectively they create a dense acoustic shadow.

Very often, ultrasound may reveal several different signs of cholelithiasis ( for example sand and stone). In this case, doctors note a complex echo structure, including signs of both formations. Cholelithiasis is dangerous because it leads to various complications, including cholecystitis, hydrocele of the gallbladder, cholestasis ( stagnation of bile in the gallbladder and liver).

Cholecystitis on ultrasound of the gallbladder

Cholecystitis is an inflammation of the gallbladder wall and most often occurs with cholelithiasis. When the outflow of bile is disrupted, pathogenic microorganisms are activated, which cause inflammation. Cholecystitis, depending on the duration of development of pathological processes, can be acute and chronic.

Acute cholecystitis occurs with severe pain symptoms and is called hepatic colic. An ultrasound reveals layering and thickening of the walls of the gallbladder, and a stone is found in the lumen of the bile ducts, which causes pain and inflammation. The gallbladder increases in size because bile does not have an outflow path and accumulates in the gallbladder, stretching it. Free fluid may be found near the bubble.

Chronic cholecystitis occurs without blockage of the biliary tract; the pain is dull and intermittent. Sometimes the process can worsen and occur like acute hepatic colic. In chronic cholecystitis, a large accumulation of stones in the gall bladder, limited or diffuse thickening of the walls of the bladder, caused by pathogenic microflora, is detected. Sometimes, with a long course of chronic cholecystitis, a decrease in the size of the bladder and its wrinkling are detected. The walls may have increased echogenicity due to the deposition of calcium salts ( so-called “porcelain” gallbladder). The prognosis in this case is unfavorable; the disease can lead to cancer.

Treatment of cholecystitis is usually surgical. Conservative treatment is not always effective, therefore, in case of repeated exacerbations, laparoscopic surgery is performed to remove the gallbladder. In this case, a small incision is made ( up to 5 cm in length) of the anterior abdominal wall and removal of the gallbladder under the control of a special intra-abdominal camera. Without a gallbladder, it is recommended to adhere to a certain diet, but its absence does not affect the quality of life.

Gallbladder polyps on ultrasound

Gallbladder polyps are growths of the mucous membrane of the gallbladder that protrude into its lumen. They usually cause no symptoms or complications. Polyps are discovered accidentally during an ultrasound examination of the abdominal cavity.

When performing an ultrasound of the abdominal cavity, the size and shape of the pancreas is always examined. Great attention is paid to the structure of the pancreas. Examination of the pancreas is of particular importance, since its diseases indicate serious disorders in the entire gastrointestinal tract. Diseases of the pancreas that can be diagnosed by ultrasound include acute and chronic pancreatitis, tumors, cysts, and congenital anomalies.

Ultrasound of a healthy pancreas

The pancreas is located behind the stomach. The structure of the pancreas consists of a head and a tail. The head is located slightly to the left of the axis of symmetry of the human body, it is surrounded by the duodenum. The tail of the pancreas is to the left, higher and extends to the root of the spleen. The body of the pancreas is separated between the head and tail. The ducts through which digestive enzymes enter the gastrointestinal tract open together with the common bile duct into the duodenum.

The pancreas is examined in the upper longitudinal and transverse plane of the abdominal cavity. Ultrasound of the pancreas is performed with a slight pressure of the sensor, which normally should not cause unpleasant pain. With deep palpation, the organ is mobile and has an elastic consistency. If the pancreas is blocked by air, you can drink 500 ml of liquid in small sips to improve visualization.

On ultrasound, the pancreas is a narrow, elongated, S-shaped organ bounded by the duodenum and spleen. Normally, it has a homogeneous structure on ultrasound, slightly more echogenic compared to the liver. The echogenicity of the pancreas is increased in older people. Changes in echogenicity are caused by fatty inclusions in the cells of the pancreas, which is observed with aging of the body.

The size of the pancreas is normal

The pancreas is small in size but oblong in shape. The dimensions of the pancreas are measured in the longitudinal and transverse plane. The vessels of the upper floor of the abdominal cavity are used as landmarks. For example, the head of the pancreas is measured in the area where the inferior vena cava passes. The head measures 25–30 mm in diameter, the body 15–20 mm, and the tail about 10 mm.

The pancreatic duct appears as a tubular structure with echogenic walls. The duct is wider in the head region and decreases towards the tail of the pancreas. The pancreatic duct has a diameter of 2 - 3 mm, and at the end part - 1.5 mm. Sometimes the diameter of the duct increases to 1 mm during deep inspiration.

Acute pancreatitis on ultrasound

Acute pancreatitis is a disease in which pancreatic tissue is destroyed by its own enzymes. In acute pancreatitis, premature activation of digestive enzymes, damage and necrosis of liver cells occurs. Acute pancreatitis in the vast majority of cases is associated with alcohol intake. Less commonly, acute pancreatitis is caused by diseases of the biliary tract, poisoning or injury.

Acute pancreatitis is a dangerous disease that can lead to rapid death. In acute pancreatitis, there are complaints of severe abdominal pain, nausea, vomiting, and bloating. Ultrasound is not the only, but informative method for diagnosing acute pancreatitis.

In acute pancreatitis, ultrasound shows the following signs:

• increase in the size of the pancreas;
• decreased echogenicity of pancreatic tissue;
• anechoic inclusions, which are areas of necrosis or hemorrhage;
• dilatation of the pancreatic duct;
• There may be swelling or free fluid in the pancreatic tissue ( anechoic cavities).

In acute pancreatitis, diseases of the biliary tract can be detected if they were the determining cause. Treatment of acute pancreatitis is carried out in accordance with the severity of the patient's condition. Therapeutic fasting and drugs that reduce pancreatic secretion are used, but in severe cases surgical treatment is performed.

Chronic pancreatitis on ultrasound

Chronic pancreatitis is a lesion of pancreatic tissue that occurs on the basis of long-term factors. In this case, the pancreas shrinks, functional cells die, cavities, stones and scars form in it. Chronic pancreatitis is very often associated with chronic cholecystitis, duodenal ulcers and other diseases of the gastrointestinal tract.

Signs of chronic pancreatitis on ultrasound are:

• decreased size of the pancreas or normal size;
• hyperechoic structure of irregular shape;
• uneven edges of the pancreas contour;
• the presence of cysts in the form of anechoic structures;
• fossils in the form of rounded hyperechoic structures with acoustic shadowing;
• dilation of the pancreatic duct more than 3 mm.

Treatment of chronic pancreatitis should be carried out comprehensively, together with treatment of the entire gastrointestinal tract. In this regard, ultrasound of the abdominal cavity is a very convenient study, as it provides information about the condition of the liver, gallbladder, stomach and intestines.

Diabetes mellitus on abdominal ultrasound

Diabetes mellitus is a hormonal disease that affects the part of the pancreas that produces insulin. Diabetes mellitus should be diagnosed as early as possible in order to begin insulin replacement therapy on time. Abdominal ultrasound is not used to diagnose diabetes, since blood sugar levels are more important. In addition, changes in pancreatic tissue characteristic of diabetes mellitus appear only after a long course of the disease.

At the onset of diabetes mellitus, ultrasound reveals a pancreas with normal internal structure. Its dimensions have been slightly increased. These changes do not allow us to confidently diagnose diabetes mellitus using ultrasound scans. With long-term diabetes mellitus, certain dystrophic changes in the structure of the pancreas are revealed.

Ultrasound reveals the following signs of damage to the pancreas by diabetes mellitus during its long-term course:

• reduction in organ size;
• heterogeneous echogenicity of the pancreas;
• the appearance of connective tissue growths – sclerosis;
• the presence of hypoechoic fatty inclusions in the gland tissue – lipomatosis.

Diabetes can be successfully controlled with medications and a healthy diet. Thanks to this, it is possible to prevent the development of complications of diabetes mellitus, including damage to the kidneys, blood vessels, and nervous system.

Pancreatic cysts and tumors

The most common local changes in the pancreas are pancreatic cysts and tumors. They can be either congenital or acquired. Cysts and tumors accompany the course of both acute and chronic pancreatitis. Tumors can be benign, which pose no threat to the body, or malignant, which are dangerous by metastasis and destruction of internal organs.

Cysts on ultrasound appear as anechoic formations. They are a cavity in the pancreatic tissue, bounded by an epithelial wall. The contents of pancreatic cysts are blood, serous fluid containing enzymes. Sometimes you can find stones in it. Cysts in chronic pancreatitis are up to 4 mm in size. Tumors, both benign and malignant, may include cysts.

Pancreatic carcinoma is the sixth most common malignant tumor in the human body. Ultrasound is traditionally considered a common test for diagnosing this disease, but ultrasound is not effective in 100% of cases. Difficulties lie in its detection and differentiation from benign tumors. X-ray methods are also used to diagnose pancreatic carcinoma ( computed tomography), laboratory blood diagnostics.

Carcinoma on ultrasound creates protrusions in the contour of the pancreas. It is a uniform echogenic formation. Aggressive infiltrative growth is indicated by peripheral outgrowths of carcinoma. When it grows into surrounding vessels, we can confidently say that the tumor is malignant. With the help of color Doppler imaging, increased blood flow around the tumor can be seen.

Ultrasound examination of the liver allows you to determine the characteristics of the organ. It is carried out in the presence of symptoms of certain diseases, as well as for preventive purposes for people at risk.

Ultrasound is a type of diagnostic procedure when, through the interaction of a device, it becomes possible to study the structure of the liver. The method is reliable and allows you to determine individual indicators and parameters.

Anatomy

The liver is one of the largest organs. Its size and weight vary depending on age.

In an adult, the weight of the organ ranges from 1300-1800 g. In newborns, it occupies almost half of the abdominal cavity.

The organ is covered on all sides by peritoneum. The exception is the gate and the back of the surface. The parenchyma is covered with a fibrous membrane.

The liver is located on the right under the diaphragm, has a triangular shape, it consists of soft pinkish-brown tissue. Average dimensions are approximately 18 cm in length and 13 cm in width. The organ consists of two lobes, which are separated from each other by a curved ligament. The right lobe is 6 times larger than the left.

The body is responsible for:

• Digestion. Plays an important role in the production of bile.
• Metabolism. All blood passes through the hepatic portal vein. It is responsible for the absorption of carbohydrates, lipids, proteins and their transformation into biologically useful materials.
• Detoxification. Hepatocytes control the quality of blood and remove toxic compounds from it.

Indications

Most often, the procedure is performed on older people, since serious pathologies of the organ may appear over the years. Indications for the procedure are:

1. Yellowness of the skin, whites of the eyes and mucous membranes.
2. Coloration of urine in a bright color with simultaneous discoloration of feces.
3. Long-term treatment using serious medications.
4. on the body and
5. Abdominal pain on the right side.
6. Feeling of heaviness after eating.
7. Strong.

A procedure is also prescribed to clarify the presence and size of a focus of inflammation in the liver, which was discovered after other research methods. Sometimes there is a suspicion of an abscess in the organs.

Ultrasound allows you to determine the diameter and size of the organ, identify the presence of deviations from the norm and analyze the structure of the tissue.

Contraindications

The procedure is painless and does not imply an aggressive effect on the body through the introduction of special drugs and liquids. The examination is carried out on an outpatient basis.

There are no absolute contraindications to it, but the study is postponed if the patient was taking medications that can change the clinical picture. Infectious skin diseases may appear in the liver projection area. Then, to prevent the spread of the disease, the date of the ultrasound is postponed.

Contraindications include the patient's consumption of alcoholic beverages and food, which cause flatulence. In this case, the possibility of making an erroneous diagnosis increases.

Preparing the patient for the procedure

It is needed to obtain more accurate information about human health. At the time of the examination, there should be no gas in the intestines, so examination on an empty stomach or with a change in diet is recommended.

A few days before the ultrasound, fiber, cabbage, whole milk, legumes, fruits and bread are excluded.

Sometimes the doctor prescribes a sorbent and an enema. Drugs such as Smecta, Activated Charcoal, and Espumezan will help reduce the amount of gas in the intestines. It is possible to take enzyme preparations, for example, Pancreatin and Creon.

Video on how to prepare for a liver ultrasound:

Methodology

The duration of the procedure is from 15 to 30 minutes. The person is placed on a couch in a supine position. Sometimes the doctor may ask you to change your position.

After the procedure, you can immediately return to your daily activities and get behind the wheel of your car. In emergency situations, liver ultrasound is performed without preparation.

The specialist asks to expose the abdominal area. A conductive gel is applied to the liver projection area. The examination using an ultrasound probe begins from the right hypochondrium. If necessary, the entire peritoneum can be examined at once. The data is displayed on the screen of the device, and the doctor uses it to make his conclusion.

Normal organ sizes in adults and children

The dimensions of a healthy liver in adults are as follows:

• The thickness of the right lobe is 110-130 cm, length – 110-150 mm.
• The maximum vertical oblique size is up to 150 mm.
• The thickness of the left lobe is 50-70 mm, height – up to 100 mm.

When studying the dimensions, the uniformity, clarity of the contour, and the condition of the veins are immediately taken into account. The liver in men and women has the same parameters. In this case, the maximum size of the hepatic artery reaches a maximum of 13 mm, the portal vein - 11-18 mm, and the hepatic veins up to 10 mm.

In children, the examination takes into account age:

But these data are for informational purposes only, since only a hepatologist or a general practitioner can judge deviations and features.

What does an ultrasound of the liver show: explanation

The structure must be assessed. The edge of the liver should be smooth. After this, the sizes of the shares are examined. After this, the parenchyma of the gland is analyzed for the presence of nodes, compactions and calcifications that form changes in the signal received by the device.

Based on the strengthening or weakening of ultrasonic waves, a functional diagnostics doctor recognizes the presence of liquid and solid formations.

Developmental anomalies

An ultrasound machine can detect a large number of anomalies, including congenital liver hypoplasia in children.

The hardware diagnostic method allows you to determine:

1. Agenesis of the right lobe of the liver and the left. The latter is more common. When the disease occurs, one lobe or part of it is missing. Additionally, other diagnostic methods are used to make a diagnosis.
2. Riedel's share. It is characterized by a change in the shape of the organ. The doctor may detect the formation of a tongue shape.
3. Additional shares. They are located above the diaphragm or in the hernial sac. They are connected to the main organ by a fibrous cord.
4. Cystic and polycystic diseases. the latter appear on the walls of organs during intrauterine development. Diseases may not manifest themselves for many years.

Diffuse parenchymal changes

With advanced processes, they indicate the presence of a serious pathological process. Anomalies and changes in liver tissue can occur in the event of disorders and severe damage to the organ.

Usually, with diffuse changes in the parenchyma, deformation or thinning of the walls of the parenchyma and surrounding tissues is formed. This leads to disruption of the integrity and normal functioning of the liver.

Any type of hepatitis, cirrhosis, an increase in the fat layer in the tissues, a sharp increase or decrease in body weight, and a long course of taking antibiotics can lead to such changes. Signs are aching pain on the right side of the abdomen, the appearance of a yellow color on the sclera, and a coating on the tongue.

Cysts

This is a focal cavitary change in the liver, manifested by pain, abdominal asymmetry, and nausea. Using ultrasound, you can find such benign formations in various segments, lobes and ligaments of the liver. The diameter usually ranges from a few millimeters to 25 cm.

Cysts in the liver are found in 0.8% of the population. They occur more often in women than in men. This disease is often combined with cholelithiasis, liver cirrhosis, and polycystic ovary syndrome.

Congenital

This type is formed as a result of a violation of the development of the ducts. It turns out to be blocked, so bile cannot come out of it. Gradually, a cavity forms. The pressure increases so much that further liver flow becomes impossible.

Congenital cysts have their own capsule. This is how they differ from other types. Ultrasound can detect both single and multiple forms.

Fluid formations are usually anechogenic. If the fluid is heterogeneous, then the echogenicity may vary.

Echinococcal

There are two forms of the disease:

1. The hydative form has the form of cysts.
2. Alveolar – tumor-like formations.

Sometimes both types are combined. On an ultrasound, the doctor will see rounded limited areas of altered liver tissue that contain fluid. Additionally, to clarify the diagnosis, an immunological test is prescribed.

Traumatic

They have a spherical or oval shape and are free from echoes. Traumatic ones develop after a central or subcapsular rupture of the liver; they can appear after treatment of a liver abscess.

Such a benign formation appears with strong blows, falls, or rib fractures.

Traumatic cysts are differentiated from hematomas. The latter do not have a clear shape or roundness. Their structure is not uniform. With progression, an ultrasound examination reveals the structure of the formation, resembling a tumor.

Tumor formations

Using liver ultrasound, you can detect both.

The first type is. It looks on the device as a simple formation with smooth contours.

Formed from vascular tissue. On ultrasound, the picture is represented by a formation with uneven contours and a heterogeneous structure.

Possible detection of the liver. This is a fatty tumor that is similar to hemanigoma and. A rare formation is biliary cystadenoma. Ultrasound shows that the walls of the cyst have a rich blood supply and multiple papillary foci.

For malignant tumors, ultrasound confirms the presence of dense formations. The technique allows you to determine the presence of such dangerous diseases as,. With a primary lesion, the ultrasound picture is varied.

Suspicion of the presence of a tumor may be caused by:

• seals in the area of ​​the portal vein branches,
• changes in the vascular pattern,
• increase in organ size,
• rounding the bottom edge
• effect of weak ultrasound conduction.

Due to the attenuation of ultrasonic waves, the image of the diaphragm becomes blurred.

Why is the organ enlarged?

The liver is said to be enlarged when its dimensions at the intersection of the organ with the right midclavicular line start from 12 cm, and the left lobe is located in the epigastric region. Such formations can be provoked by both formations and:

An increase can be assumed by the appearance of heaviness in the right side, emotional instability, changes in color and stool. Dangerous consequences include oncological processes, cirrhosis and the development of liver failure.

Liver enlargement is not a disease. This is a symptom of the disease, indicating that the organ ceases to perform its functions.

The concept of grain

The liver consists of cells that are slightly flattened. Thanks to this, we can talk about the porous structure of the organ. This is necessary for the organ to function properly.

Normally, the internal structure of the liver is fine-grained and soft.

Pathological processes develop gradually.

Medium or coarse grain appears first. The latter indicates the appearance of hepatitis, severe obesity or the presence of diabetes mellitus.

Ultrasound can show a significant increase in segments of the liver structure and heterogeneity of the lymph nodes.

Elastography study

This method is used to assess the severity of fibrosis. With a regular ultrasound, the first stages of fibrosis, cirrhosis and hepatitis look the same. Previously, it was used to make an accurate diagnosis. This procedure is expensive and has many side effects.

The elastographic technique makes it possible to make an adequate diagnosis. Transient ultrasound elastometry is performed through the intercostal spaces.

A special device has an ultrasound sensor with a source of low-frequency vibrations. They reach the desired tissues and are then transformed into electromagnetic waves. This method determines the speed of wave distribution, which depends on the elastic component.

With the method, two modes are performed simultaneously, thanks to which an ultrasound picture of the liver and color mapping that evaluates tissue density are visible. This research method gives a complete picture of the pathological process developing in the liver.

Where can I get tested?

A routine liver ultrasound can be performed both in a clinic and during treatment in a hospital. Typically, you should sign up for the procedure in advance at the reception desk or through the website of the selected institution. Diagnostics are also carried out in various medical centers, which are located in all major cities.

Price

The most expensive research method is ultrasound with elastography. In Moscow and St. Petersburg, 2-3 years ago it could be completed for 7 thousand rubles. Today prices are more affordable, so on average the procedure will cost 4 thousand.

Prices for classic ultrasound examination start from 700 rubles.

Thus, liver ultrasound can be performed in almost any clinic. This is a harmless procedure that allows you to identify the presence of pathology in the organ. As the disease develops, it becomes sensitive and vulnerable to any influence. Liver ultrasound is performed for children, pregnant women and those who are contraindicated for MRI with contrast.

Content

Correct diagnosis of a disease is already halfway to its cure, which is why it is so important to use modern and fast techniques in this process. So, if the organs located in the abdominal cavity are concerned, an ultrasound examination is a procedure that cannot be avoided. Find out what signs of possible diseases the analysis can show.

What is included in an abdominal ultrasound

This type of diagnostics is used very widely today, because the abdominal cavity contains the internal organs of a person, which are responsible for various functions of the body. With ultrasound, OBP is examined:

• gastrointestinal tract, which includes the stomach, intestines;
• pancreas;
• lymphatic organs: spleen, abdominal lymph nodes;
• gallbladder;
• liver;
• retroperitoneal space: kidneys and adrenal glands, abdominal aorta, inferior vena cava;
• genitourinary organs: ureters and bladder, prostate gland in men, uterus and appendages in women.

Using ultrasound, a doctor can quickly obtain detailed information about the condition of the organ in question, and for the patient such manipulations are painless and harmless. Decoding the data from this study helps to timely identify various pathologies that have begun to develop in the body, for example:

• organ cyst;
• single or multiple abscesses;
• tumor in the abdomen;
• fluid in the abdominal cavity;
• abnormalities of fetal development during pregnancy.

The size of the spleen is normal

The main reason when a doctor examines this organ in detail is its enlargement. An ultrasound of the spleen should also be done if the patient has had an abdominal injury and there is a suspicion of its rupture and internal bleeding. The doctor needs to evaluate:

• Do the contour and dimensions of the organ differ from the norm, which for adults are:
  • thickness – 4-5 cm;
  • width – 6-8 cm;
  • length – 11-12 cm.
• Calculate the area of ​​the spleen; for this characteristic, values ​​from 15.5 to 23.5 square meters are considered normal. cm.
• Are there any neoplasms or tissue damage?
• How it is located relative to adjacent organs.

What does an ultrasound of the stomach show?

Such a study is often prescribed not only if the patient has complaints of pain in the organ, but also as preventive measures for the timely detection of an incipient disease or to evaluate the results of treatment. When deciphering an ultrasound of the abdominal cavity, close attention is paid to data on the condition of the stomach, because with such a diagnosis it is possible to identify:

• hiatal hernia;
• esophagitis is an inflammatory disease of the esophageal mucosa;
• gastroesophageal reflux disease;
• tumors;
• if necessary, detect foreign bodies.

Although this type of diagnosis in certain cases will not replace endoscopic or x-ray examination, the doctor cannot do without it when monitoring the chronic course of certain diseases, for example, gastritis or peptic ulcer. When deciphering an ultrasound of the gastrointestinal tract, the following is determined in a quick and painless way:

• swelling of the walls of the organ and lack of wall delineation;
• stomach ulcer;
• veins dilated due to varicose veins;
• diffuse neoplastic wall thickening;
• pyloric stenosis – congenital or acquired;
• gastric carcinoma ;
• lymphoma and other dangerous illnesses.

Normal liver sizes according to ultrasound in adults

This organ consists of two unequally sized lobes, and normally it should have a homogeneous echostructure and be interrupted only by the portal vein and the branches of this blood vessel.
An important criterion that is paid attention to during diagnosis is the liver’s compliance with the following parameters defined for adult patients:

• length:
  • glands – 14-18 cm;
  • right lobe – 11-15 cm;
• size in diameter – 20-22.5 cm;
• right lobe, oblique vertical size – up to 15 cm;
• height of the left lobe – up to 10 cm;
• sagittal size – from 9 to 12 cm;
• lobe thickness:
  • right - up to 12.5 cm;
  • left – up to 7 cm.

What does an ultrasound of the liver show? If, when deciphering the results, an increase is indicated, this clearly indicates the development of pathological processes in it, for example, cirrhosis or hepatitis. Another important indicator is that the shape of the lower corner of the organ should be pointed: in the area of ​​the left lobe - no more than 45 degrees, in the right - no more than 75 degrees. When diagnosing, you need to pay attention to the visualization of the vessels passing through the liver, because one of the main functions of the gland is blood filtration.

During an ultrasound examination, they look at the structure of the liver and how clear and even the contours of the organ are, and whether the gland has good sound conductivity. Deviations in the values ​​of these parameters always indicate the presence of problems in the functioning of the organ. So, if increased density is visible during diagnosis, we can talk about diffuse changes and dysfunction of this natural filter. Ultrasound diagnostics can also examine calcifications in the liver - deposits of calcium salts that have arisen after the patient has suffered serious illnesses.

What does a kidney ultrasound show?

These paired bean-shaped organs perform the function of cleansing the body of harmful substances by removing them along with the human waste product - urine. Interpretation of ultrasound of the abdominal cavity always includes such parameters as structure, shape, location. The right kidney should be located slightly lower than the left, and the difference in their sizes should not exceed 2 cm. The following numbers characterizing the parameters of these urinary organs are considered normal for an adult:

• length – 10-12 cm;
• bud thickness – 4-5 cm;
• width – 5-6 cm;
• parenchyma thickness – up to 2.3 cm.

Ultrasound of the kidneys can reveal the following abnormalities in their functioning:

• abnormalities of blood vessels: narrowing of the renal artery, appearance of additional veins;
• formation of kidney stones;
• chronic pyelonephritis is a process of inflammation of organ tissues, which leads to disruption of the normal outflow of urine;
• dilatation of the renal pelvis - pyeloectasia;
• cyst;
• tumors: benign or malignant.

Gallbladder size, normal in adults

This pear-shaped organ is located at the bottom of the liver in a separate recess and is closed by the peritoneum from the abdominal cavity. It collects bile produced by the liver, and then regulates its supply to the gastrointestinal tract. Interpretation of an ultrasound scan of the gallbladder gives an idea of ​​its shape, size, condition of the walls, volume and internal contents. For adult patients, the following indicators identified during the examination are considered normal:

• the distance from the bottom of the bubble to the narrowest lobe is 6-10 cm;
• organ width – up to 5 cm;
• wall thickness – does not exceed 4 mm;
• volume varies from 30 to 50 ml.

Common bile duct

When deciphering an ultrasound of the abdominal cavity, you need to pay attention to the data about this tubular formation, which doctors also call the common bile duct. The length of the bile duct can vary from 2 to 12 cm. The internal diameter of the common bile duct in different parts of this formation can be from 2 to 8 mm. The doctor needs to consider whether this value at the widest part of the formation does not exceed 8 mm. By interpreting the ultrasound diagnosis of the common bile duct, a specialist can see the stones formed in it and establish a diagnosis of choledocholithiasis.

Ultrasound of the pancreas

The importance of examining this organ is explained by the fact that insulin synthesis occurs in it, and timely noticed deviations in its work make it possible to take measures to prevent serious pathological changes in the body. When interpreting study data, you need to pay attention not only to the size of the pancreas, but also to its echogenicity (image brightness) and the clarity of its contours. All parts of the gland should be clearly visualized on the screen:

• head – normally its thickness does not exceed 3.2 cm;
• organ body – up to 2.5 cm;
• tail – up to 3.0 cm.

The ultrasound specialist should carefully examine the diameter of the Wirsung duct. This figure should normally be 1.5-2 mm, and in response to intravenous administration of secretin, expand to 2.5-5 mm. Dilation of the Wirsung duct or lack of response to the supply of this hormone indicates the development of an inflammatory process - pancreatitis. Often, deformations in this area occur with the development of a tumor of the head of the pancreas. An experienced doctor will be able to see abscesses, areas of necrosis and the presence of stones blocking the ducts using an ultrasound examination of the organ.

How to decipher ultrasound results

Self-analysis of ultrasound data for a person without special medical education in the vast majority of cases will not reveal a clear picture of his state of health. A complete and accurate interpretation of an abdominal ultrasound should be carried out either by an ultrasound specialist or by the attending physician who referred the patient for such an analysis.

Ultrasound examination is a high-precision diagnostic technique that allows you to detect various pathologies in the cavities and organs of the human body. In other words, this method will allow the doctor to see something that is not visible during a normal examination.

Ultrasound of the liver and abdominal cavity is used to diagnose almost all diseases of the digestive system. This method is quite simple and today is available to all medical institutions.

What is ultrasound

Ultrasound research is a method based on the ability of ultrasonic waves to penetrate into the body and be reflected from tissues of different densities at different speeds. Due to this, an image of internal organs appears on the computer screen, colored in different shades.

Denser fabrics are dyed more intensely, softer ones - pale shades. Typically, ultrasound images are black and white, so organs appear in all shades of gray and black. The image is obtained in a two-dimensional plane - slices. You can evaluate the consistency of the organ, its homogeneity, the presence of liquid contents in the cavities, foreign bodies or stones.

How to prepare a patient for an abdominal ultrasound

Such an examination should be performed on an empty stomach, that is, the last meal should be no later than 12 hours before the diagnosis. In addition, it is necessary to eliminate all symptoms of flatulence so that the image is clearer and all abdominal organs are visible. This procedure is called preliminary preparation.

To achieve this, it is recommended to switch to a low-carbohydrate diet three days before the test, eliminating legumes, carbonated drinks, milk, and brown bread. To prepare for the study if there is severe flatulence on the eve of the procedure, it is recommended to take Espumisan or other products containing simethicone. If the patient has constipation, a cleansing enema is prescribed. To conduct an ultrasound, children are also recommended to follow a diet and use drugs with simethicone - Bebinos, Sub-simplex. Children's Fortrans is prescribed to cleanse the intestines. If the examination is emergency, no special preparation is required.

Image may not be accurate due to flatulence

When should it be carried out?

Ultrasound is a method used in routine and emergency diagnostics. Hardware examination of the abdominal cavity is used to diagnose the following conditions:

• Injury to the abdominal cavity - to detect the appearance of free fluid (blood).
• To determine the relative position of internal organs.
• Diagnosis of pathology in the liver and gall bladder.
• Assessment of the condition of the spleen.
• Diagnosis of pancreatic pathology.

How is the procedure carried out?

An ultrasound examination of the abdominal cavity is performed by an ophthalmologist. The patient should be in a supine position. Before the start of the study, a special gel is applied to the anterior abdominal wall - it improves the contact between the device’s sensor and the skin and the passage of ultrasonic waves. If necessary, the doctor may ask the patient to turn on his right or left side. The ultrasound machine can operate in different programs - the doctor selects the one necessary for a given patient.

What can be seen with an abdominal ultrasound

The study allows us to give a complete assessment of the condition of the internal organs and the cavity itself:

• Organ sizes: liver, gall bladder with ducts, spleen, pancreas.
• The shape of organs and their relative positions.
• Integrity of internal organs, presence of cysts, tumors, stones.
• The presence of fluid in the abdominal cavity - using an ultrasound examination, fluid in an amount of 20 ml can be detected.
• Hollow organs - the stomach and intestinal loops - are usually not visible unless they are filled with gas.
• The condition of the abdominal aorta and nerve plexuses can be assessed.
• Organs that are located retroperitoneally are also examined - kidneys, adrenal glands.

Ultrasound is a fairly informative method that allows you to detect even minor pathologies.

An abdominal ultrasound can show various organs, such as the spleen.

What diseases are diagnosed using abdominal ultrasound

The first group of diseases are pathologies of the digestive organs:

• cholecystitis - calculous and acalculous;
• purulent diseases of the gallbladder and bile ducts;
• improper development of internal organs;
• liver diseases;
• cysts and purulent diseases of the pancreas.

The second group includes pathologies of the urinary organs and adrenal glands:

• kidney diseases - tumors, inflammations, cysts;
• pathology of the ureters;
• urolithiasis.

In addition to diseases of the internal organs, one can detect the presence of free fluid between the layers of the peritoneum and pathology of the abdominal aorta.

How is liver ultrasound performed?

Ultrasound of the liver can be performed in different positions – both of the patient and the device’s sensor. This allows you to examine the organ comprehensively. The liver is assessed in longitudinal, oblique and transverse positions of the sensor. For greater accuracy, the sensor can be rotated in a circular motion.

How is the liver assessed by ultrasound?

To assess the ultrasound condition of the liver, a number of criteria are used:

• Position of the organ in the abdominal cavity - its normal location is the area of ​​the right hypochondrium.
• Mobility of the liver during respiratory movements - normally, its edge should shift by 5-6 cm during breathing.
• Evenness and clarity of the outline of the organ, absence of bulges and recesses.
• The dimensions of the organ are anteroposterior and superior-inferior.
• The condition of the parenchyma is that it is normally homogeneous and has normal echogenicity (equal to the echogenicity of the kidney parenchyma).
• Visibility of blood vessels.

Ultrasound can assess the size of the organ

When should it be carried out?

An ultrasound of the liver is performed if a number of diseases are suspected:

• Echinococcosis and alveococcosis - cysts containing helminths may be detected.
• Hepatic or subphrenic abscess.
• Jaundice of unknown origin.
• Viral hepatitis - the degree of fibrosis of the organ parenchyma is assessed.
• Metabolic diseases - fatty hepatosis, Wilson-Konovalov disease.
• Liver tumors.
• The patient complains of heaviness and pain in the liver, nausea and vomiting after eating.
• A penetrating wound to the right hypochondrium or a blunt blow to the liver area - to determine the degree of rupture and subcapsular hematoma.

Ultrasound examination of the abdominal cavity is safe for the patient because it is non-invasive and does not carry an x-ray load. Can be used in young children and people with severe concomitant diseases. Ultrasound today is a publicly available method and can be performed in any medical institution.

What is abdominal ultrasound?

Ultrasound examination (ultrasound) of the abdominal organs - diagnostic examination of the liver, gallbladder, spleen, pancreas using ultrasound.

During the study, the size, structure, homogeneity and contours of internal organs are assessed. Ultrasound examination of the abdominal cavity can detect inflammation, neoplasms and other changes.

An abdominal ultrasound is a simple but effective test that allows doctors to assess the condition of internal organs. The absolute safety of ultrasound allows its use in all areas of modern medicine. Ultrasound of the abdominal cavity allows you to simply and accurately detect even the most minor changes in the body.

As a rule, the abdominal ultrasound procedure itself takes no more than 20 minutes and is completely painless for patients.

When should an abdominal ultrasound be performed?

An abdominal ultrasound should be performed if the patient experiences symptoms such as:

pain or heaviness in the stomach and a feeling of fullness after eating,

heaviness in the right hypochondrium,

pain in the abdomen (especially in the upper part),

sharp pain in the lower abdomen,

bitterness or dry mouth,

active gas formation

frequent constipation,

frequent vomiting or regurgitation,

• preoperative preparation.

What diseases can be diagnosed by abdominal ultrasound?

Ultrasound of the abdominal organs is most often performed according to doctor's indications. Ultrasound of the abdominal cavity makes it possible to assess the presence and severity of the following pathologies:

the presence of stones in the gall bladder;

changes in the structure of the liver;

degeneration of liver cells into adipose tissue (liver dystrophy);

hepatitis of varying severity;

cirrhosis;

the presence of neoplasms when cancer is suspected;

changes in the condition of the lymph nodes and their size, for example, if an infectious process caused by bacteria or viruses is suspected;

the presence of thickening of the walls of the gallbladder, polyps;

disturbances of intestinal motility, if there is pain and disruption of the gastrointestinal tract;

disturbances in the structure of the abdominal organs and the degree of disturbances and damage if mechanical injuries occur;

effective equipment makes it possible to study blood flow in organs, which makes it possible to identify a number of diseases associated with the pathology of the vascular system.

How to properly prepare for an abdominal ultrasound?

Proper preparation for abdominal ultrasound is of great importance for objective results of the study.

The fact is that if at the time of the study there are gases and a large accumulation of air in the patient’s large intestine or in another area being examined, then the study itself may be difficult and its results distorted. In such a situation, the ultrasonic beam will simply not be able to penetrate to the required depth.

Therefore, before performing an abdominal ultrasound, it is very important to follow a special diet.

The dietary regimen should be started 3 days before the study. Raw vegetables, which contain large quantities of fiber, dairy products, especially whole milk, all types of legumes, fizzy drinks, high-calorie confectionery products (cakes, pastries), and rye bakery products should be completely excluded from the nutritious diet.

If there is difficulty in digestion or increased intestinal flatulence, then a few days before the test you should start taking medications that can reduce gas formation (enzyme preparations and enterosorbents).

Immediately on the day of the examination, it is necessary to exclude breakfast, as well as other meals before the examination. On the day before the ultrasound, you should eat only light dietary foods.

For patients who suffer from diabetes, a small light breakfast (warm tea, dried white bread) is acceptable before an abdominal ultrasound.

You should refrain from smoking at least an hour before the test, as smoking causes stomach contractions, which may lead to the doctor making an incorrect diagnosis.

If you are taking any medications, you should inform your doctor about this before the study.

There is no need to do a cleansing enema.

How is an abdominal ultrasound performed?

During the examination, the patient lies on his back. The technician applies a clear gel to the sensor to fill the air gap between the sensor and the skin. Sometimes the patient is asked to hold his breath briefly after taking a deep breath so that the image of the internal organs is clearer.

The abdominal ultrasound procedure is absolutely painless and safe.

Are there contraindications and restrictions for performing abdominal ultrasound?

Ultrasound diagnostics has no contraindications and is prescribed even to children and women during the period of feeding and childbearing.

Abdominal ultrasound results

The ultrasound specialist will tell you the results of the ultrasound examination immediately after the diagnosis. The conclusion and all necessary photographs are given to the patient.

You may be scheduled to visit related specialists, undergo additional tests and repeat ultrasound, and also be recommended for additional diagnostics (for example, MRI, biopsy, etc.)

Doctors from the MEDOC antenatal clinic network have extensive experience in performing abdominal ultrasound. Highly qualified doctors are able to identify the most minor deviations from the norm in the organs being examined and prescribe timely, competent treatment.