A liver ultrasound is a non-invasive imaging procedure that uses high-frequency sound waves to create real-time images of the liver and surrounding organs. It visualizes the liver’s size, shape, and structure without radiation. Doctors often order it to investigate symptoms like abdominal pain, jaundice, or abnormal liver function test results. It helps evaluate the liver’s condition and identify potential issues.
How Ultrasound Works
Ultrasound technology relies on sound wave reflection to image internal body structures. A handheld transducer is placed on the skin over the area examined. This transducer emits high-frequency sound waves that travel into the body and interact with various tissues and organs.
Sound waves encounter different tissue densities, bouncing back as echoes to the transducer. The transducer captures returning echoes, converting them into electrical signals. A computer processes these signals to construct a dynamic, two-dimensional image. Tissue reflection of sound waves is called “echogenicity”; denser tissues appear brighter, fluid-filled areas darker.
What a Healthy Liver Looks Like
A healthy liver on ultrasound presents a consistent, uniform appearance. Its size and shape fall within expected ranges, appearing as a large, wedge-shaped organ in the upper right abdomen. The borders of a normal liver are smooth and well-defined, indicating a healthy outer capsule.
The internal texture (parenchyma) of a healthy liver exhibits a fine, homogeneous echotexture. Tissue appears evenly speckled with moderate brightness, without large, irregular dark or bright areas. Normal blood vessels (hepatic and portal veins) are visible as anechoic (dark) tubular structures branching throughout. The gallbladder, seen adjacent to the liver, appears as a dark, pear-shaped structure, filled with fluid.
Common Abnormal Findings
Deviations from a healthy liver indicate various conditions. Fatty liver (hepatic steatosis) is a common finding, appearing as abnormally bright or hyperechoic liver parenchyma. Increased brightness results from fat accumulation within liver cells, making the liver more reflective than adjacent kidney tissue. Its severity varies, sometimes obscuring blood vessel visibility.
Other frequent findings include simple liver cysts: fluid-filled sacs appearing as well-defined, anechoic (black) lesions with thin walls and enhanced through-transmission of sound. They have clear, sharp borders and do not reflect sound, indicating fluid content. Gallstones, in the gallbladder, appear as bright, echogenic structures within the anechoic lumen, casting an acoustic shadow.
Solid masses vary in appearance but disrupt the normal homogeneous echotexture. They may appear hyperechoic (bright), hypoechoic (dark), or isoechoic (similar brightness) relative to liver tissue. Borders can be regular or irregular, and internal texture may be heterogeneous, indicating different tissue composition. Any solid mass warrants further investigation.
Understanding Your Report and Next Steps
After your liver ultrasound, images are reviewed and interpreted by a radiologist, a medical imaging specialist. The radiologist compiles a detailed report summarizing findings, sent to your referring physician. The report describes your liver’s appearance and other relevant structures, noting normal appearance or identified abnormalities.
An ultrasound report provides observations, not a definitive diagnosis. Your physician discusses results, explaining findings in the context of your health, symptoms, and other tests. Only a qualified medical professional can provide an accurate diagnosis and recommend treatment.
Findings are sometimes inconclusive or require clarification. Additional imaging (CT, MRI) or a biopsy may be recommended for a definitive diagnosis. Follow-up scans may monitor conditions or observe changes.