Liver disease has many causes, sometimes it can be caused by problems with the liver tissue being inflamed (e.g. Hepatitis), the blood supply to the liver being altered (e.g. Portal Vein Clots) or problems with the bile ducts (e.g. Primary Sclerosing Cholangitis).
An ultrasound is a way of looking at the blood flow into and out of liver, the structure of the liver tissue and the size of the bile ducts. It can also give an indication of whether there is excessive fat present in the liver, which is linked to the development of liver disease. Ultrasound can also demonstrate areas that are abnormal, such as the presence of liver abscess, gallstones or liver cancer.
Abdominal ultrasound can also assess other structures in the abdomen, including the pancreas, spleen and kidneys. It may also identify fluid build-up (ascites) in your abdominal cavity.
There are lots of reasons we may wish to perform an ultrasound scan.
We may use it as part of the diagnostic process, to see if there are any problems with the structure of the liver or bile ducts that can identify the cause of your liver disease.
We may repeat your ultrasound test if there are signs your liver disease has changed in some way, for instance if you have a variceal bleed, we may repeat your scan to check for a blood clot.
We may perform an ultrasound to identify the presence of ascites, or to look at other organs in the abdomen such as your pancreas.
We may use the test as part of your regular monitoring. If you have a diagnosis of cirrhosis you are at higher risk of liver cancer known as Hepatocellular Carcinoma, we may wish to undertake surveillance if you are considered at high risk of this complication. In this case we may wish to perform an ultrasound every 6 months to monitor your liver for cancerous changes.
An ultrasound takes place in the radiology department by a specialist ultrasound operator.
You are usually required to be “nil by mouth” for a few hours before the test. This gives us the best views of the gallbladder. You may also be asked not to pass urine or to drink water to allow your urinary bladder to fill, depending on the reason for the ultrasound.
You will be asked to lie on your back with your stomach exposed.
A water based gel will be applied to the scan area, this is cold. The person performing the scan will place the probe onto your stomach and move around the areas that they wish to see. The operator will apply firm pressure with the probe and may press harder in some areas to enable the best views. You may also be asked to roll onto your side during the procedure.
The test usually takes 5-10 minutes.
After the test there are no special instructions to follow, you can continue as normal.
The scan operator will send the test results to a radiologist (a doctor specialising in these tests), who will review the images and create a report on the findings.
The report will be sent on to the doctor or nurse who requested your test, who will be able to interpret it along with the medical history, blood tests and any other results. No single test will diagnose the cause and extent of your liver disease.
In some cases we may not be able to get the required information from an ultrasound. In this instance the information will be passed onto the doctor or nurse who requested the test for them to decide the best next steps.
Depending on the underlying cause of your liver disease, you may be required to have further repeat ultrasound tests; If you have cirrhosis or are considered high risk for developing liver cancer you may be asked to have an ultrasound every 6 months. You will be informed if this is the case.
Ultrasound is a non-invasive test that is quick and can give us a good idea of the structure of your liver, however, it is your choice if you do not wish to have the test.
You should discuss alternative options with your doctor or nurse specialist, these may include other ways of taking images of the liver, blood test monitoring or a liver biopsy. Alternative options will depend on the cause of your liver disease and the reason for performing the test.