Ultrasound Procedures for Liver Examination

Ultrasound Procedures

• Ultrasound Position and Imaging Orientation: Positioning for ultrasound exams involves recumbency (lateral or dorsal) and specific frequency (6.5-8.5 MHz, 7 MHz general use) adjustments. Sagittal plane positioning is cranial on the left of the screen, while transverse plane is right side on the left side of the screen.

Liver Ultrasound Exam

• Location: Deepest part of cranial abdomen, caudal to diaphragm. Lower resonant frequency probe needed.
• Technique: Position transducer sagittally caudal to the xiphoid process. Tilt towards the shoulder, adjust depth to view diaphragm. Fan transducer sagittally (middle, left, right), then rotate to transverse plane for liver and diaphragm views.
• Findings: Medium echogenicity (reflects sound waves), homogeneous texture, anechoic gall bladder (right of midline), and visible hepatic/portal veins (portal hyperechoic).
• Guidelines: Observe echogenicity, homogeneity, and inter-lobe line changes for abnormalities.

Spleen Ultrasound Exam

• Location/Size: Variable in size, near left kidney. Tail may extend to the right. Lies superficial on the left abdominal wall.
• Technique: Start sagittally, caudal to xiphoid. Scan from tail to head (sagittal to frontal). Push under left costal arch for head in frontal plane.
• Findings: Homogeneous, medium echogenicity. Hyperechoic capsule, anechoic blood vessels.
• Guidelines: Ensure full view from tail to head of the spleen.

Stomach Ultrasound Exam

• Location: Primarily left of midline, caudal to liver. Pylorus on the right
• Technique: Position transducer caudal to xiphoid, sagittally. Scan left for fundus and body, and right for pylorus. Rotate and fan transversally, cranially, and caudally.
• Findings: Five-layered alternating hypo/hyperechoic wall appearance. Observe contents, rugal folds, peristalsis, and wall layers. Gas may obscure deep structures.
• Considerations: Gas creates reverberation and shadowing artifacts

Small Intestine Ultrasound Exam

• Initial Plane: Sagittal plane in mid-abdomen.
• Examining Quadrants: Include all four abdominal quadrants.
• Tracking Loops: Trace loops in transverse and longitudinal views.
• Findings: Luminal Contents, Thickness & Motility. Potential for gas-induced acoustic shadowing.

Kidney Ultrasound Exam

• Frequency: 5-7.5 MHz for large dogs; 7-12 MHz for small dogs.
• Location: Left kidney more caudal. Position transducer caudal to xiphoid process.
• Technique: Place transducer sagittally, generate longitudinal view and rotate for transverse view.
• Findings: Visualize all renal layers: capsule, cortex, medulla, pelvis. Look for acoustic shadowing, which may indicate kidney stones.

Bladder Ultrasound Exam

• Initial Plane: Sagittal from caudal midline to the lateral prepuce (or equivalent in females). Higher frequency probe for better resolution.
• Technique: Identify a filled bladder with anechoic fluid. Fan transducer left/right, then transverse view. Identify bladder wall layers (submucosa, muscularis, serosa). Also measure wall thickness.
• Findings: Look for abnormal projections, hyperechoic stones, or shadowing.

Colon Ultrasound Exam

• Initial Plane: Sagittally, ventral abdomen, left of midline near descending colon
• Identifying the Colon: Scan for a large diameter intestine with slower peristalsis. Use transverse views to better locate using the nearby bladder.
• Findings: Observe all colon layering, noting any pattern changes. Gas-induced shadowing may limit view to near the wall.

Test your knowledge on ultrasound procedures and techniques for liver examinations. This quiz covers positioning, equipment settings, and key findings associated with liver ultrasounds. Enhance your understanding of how to accurately interpret liver imaging results.