Diffuse Liver Lesions

Dr. Alison Harris and Dr. Rathy Kirke

Dr. Alison Harris and Dr. Rathy Kirke. Ultrasonography is often the first modality used to image patients who present with right upper quadrant pain or deranged liver function tests. The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing, and may progress to steatohepatitis and eventually cirrhosis. Cirrhosis is associated with certain risk factors and ultrasound is often utilized to assess for the complications of cirrhosis, such as hepatocellular carcinoma and portal hypertension. Greyscale and Doppler imaging are usually performed for a complete evaluation. Though a thorough assessment of the liver can be limited by patient body habitus or a high location of the liver, attention to subtle changes in the parenchymal architecture and in the Doppler waveforms can improve diagnostic specificity. Other diffuse parenchymal liver diseases encountered in clinical practice include neoplastic infiltration, auto immune causes, vascular disease such as Budd-Chiari syndrome, and atypical infections. An overview of NAFLD and cirrhosis will be given and emerging techniques, such as contrast-enhanced ultrasound (CEUS) and non-invasive methods of assessing fibrosis will be discussed.

PlayView Lecture