Sonographic Eval Of Liver

Question 0

Patient position?

Answer 0

Supine or right anterior oblique position

Deep inspirations will allow liver to move inferior to the rib cage

Question 1

Patient prep?

Answer 1

NPO for 6 hrs to eliminate bowel and gas and ensure fullness of gallbladder

Question 2

Transducer size?

Answer 2

Average Adult - 2.5 to 5 MHz
Slender adult or child - 5 to 7 MHz
Neonate - 7.5 to 12 MHz

Question 3

Assessment criteria?

Answer 3

Size of liver in longitudinal plane
Attenuation of liver parenchyma
Liver texture
Presences of hepatic vascular structures, ligaments, and fissures

Question 4

What is the liver protocol?

Answer 4

Long left lobe inferior & superior margins
Long left lobe inferior & superior margins with aorta
Long left lobe w/ diaphragm, caudate lobe, & ligamentum venosum
Long right lobe w/ IVC where it passes through liver
Long right lobe w/ main lobar fissure, gallbladder, & portal vein
Long right lobe w/ mid clavicular line (measurement)
Long right lobe w/ part of right kidney
Long right lobe w/ dome & adjacent pleural space
Trans left lobe w/ lateral margins
Trans left lobe w/ ligamentum teres
Trans left lobe w/ left hepatic vein
Trans right lobe w/ right hepatic vein
Trans right lobe w/ portal vein
Trans right lobe lateral
Trans right lobe w/ dome & adjacent pleural space

Question 5

Most important this to remember when scanning?

Answer 5

SWEEP

Question 6

What is another position to try if can’t see liver supine?

Answer 6

LLD

Question 7

What do you need to do if an abnormality is found?

Answer 7

Measure it and make sure you see it in 2 planes