Liver

Question 1

where is the normal liver?

Answer 1

under costal arch
between stomach and diaphragm

Question 2

what is the echogenicity of the liver in dogs?

Answer 2

hypoechoic to spleen
iso- or hyperechoic to kidney

Question 3

what is the echogenicity of the falciform ligament compared to the liver in a cat?

Answer 3

iso- or hyperechoic to liver

Question 4

what can indicate an enlarged liver on radiographs?

Answer 4

rounded margins
protruding beyond costal arch

Question 5

what is the normal size of the common bile duct?

Answer 5

1-3mm in dogs
up to 4mm in cats

Question 6

what are the walls of the portal veins like?

Answer 6

always hyperechoic

Question 7

what does heptic cirrhosis look like?

Answer 7

small
irregular contour/lobular
hyperechoic
hypoechoic nodules

Question 8

what are hepatic cysts like?

Answer 8

single or multiple
thin-walled or no visible wall
anechoic
posterior enhancement
can be very large

Question 9

what can hepatic cysts be associated with?

Answer 9

polycystic renal disease
pancreatic cysts

Question 10

what does hepatocellular carcinoma look like?

Answer 10

single or multifocal hyperechoic masses

Question 11

what is cholecystolithiasis?

Answer 11

calculi in the gall bladder and biliary tree

Question 12

what can cause gall bladder wall edema?

Answer 12

anaphylaxis
portal hypertension
hypoalbuminemia
biliary obstruction
inflammation

Question 13

what are the patterns of gall bladder mucocele?

Answer 13

stellate
kiwi-fruit

Question 14

what should you look at for the liver?

Answer 14

gallbladder
veins
diaphragm
falciform ligament

Question 15

where is the gallbladder?

Answer 15

between quadrate and right medial lobes in dog
in fissure of right medial lobe in cat

Question 16

what is the gallbladder wall like?

Answer 16

very thin: <1mm

Question 17

what are hepatic veins like?

Answer 17

wall not visible or hyperechoic if ultrasound beam is perpendicular

Question 18

what are the possible diffuse changes of the liver?

Answer 18

hyperechoic
hypoechoic
mixed echogenicity

Question 19

what common things can cause a hypoechoic liver?

Answer 19

passive congestion
acute hepatitis
leptospirosis
lymphoma: can also be hyperechoic and mixed

Question 20

what common things can cause mixed echogenicity in the liver?

Answer 20

steroid hepatopathy + regenerative nodules
if no nodules: hyperechoic

Question 21

how can you tell a liver is diffusely hypoechoic?

Answer 21

prominent portal vein walls
liver of normal size or enlarged

Question 22

what can cause focal liver parenchyma changes?

Answer 22

nodular hyperplasia
cyst
abscess
hematoma
granuloma
neoplasia

Question 23

what is nodular hyperplasia like on ultrasound?

Answer 23

hypoechoic
target lesions
hyperechoic

Question 24

what is cystadenoma like?

Answer 24

benign, epithelial
hyperechoic mass with numerous variable size cysts
common in older cats

Question 25

what do hepatoma and adenoma look like?

Answer 25

coarse echotexture nearly isoechoic to normal liver

Question 26

what is lymphoma like?

Answer 26

diffuse, can be hypoechoic or hyperechoic
multifocal, hypoechoic

Question 27

are target lesions more likely to be benign or malignant?

Answer 27

malignant, especially if multiple (81%)

Question 28

what would indicate an extrahepatic biliary obstruction?

Answer 28

common bile duct >5mm
intrahepatic biliary tree distention
gallbladder distention is not a reliable sign

Question 29

what make up cholecystolithiasis?

Answer 29

cholesterol
bilirubin
calcium
magnesium
oxalates

Question 30

what is cholecystitis on ultrasound?

Answer 30

thickened gallbladder wall > 1mm

Question 31

which animals commonly get gallbladder mucoceles?

Answer 31

small breeds
older dogs
cocker spaniels
shelties

Question 32

what does a ruptured gallbladder mucocele look like on ultrasound?

Answer 32

focal steatitis- bright fat
focal free fluid
thickened, ill-defined gallbladder wall
kiwi-fruit pattern floating in abdomen