Ultrasound in Rare Diffuse Liver Disease

Abstract

Ultrasound is often the first imaging procedure performed in the evaluation of individuals with suspected or known liver disease. Despite technical advances in ultrasound techniques, sonographic detection and evaluation of diffuse liver disease still remains difficult. This is due to the fact that diffuse liver disease does not always cause distortion of the liver parenchymal texture, internal liver architecture, or shape of the liver. On the other hand, the size of the liver, the echo pattern of the hepatic parenchyma, the analysis of intrahepatic vessels and alterations in perihepatic structures and lymph nodes can be helpful sonographic parameters of diffuse liver disease. Until now, the sonographic appearance of some rare diffuse liver diseases is not well known. However, there are some typical sonomorphological signs that, once identified, can facilitate the differentiation between various diseases. The aim of this paper is to highlight some typical ultrasound findings of liver parenchyma and perihepatic lymph node structures in rare diffuse liver diseases based on a review of published data.

Zusammenfassung

Die transabdominelle Sonografie ist häufig das erste bildgebende Verfahren zur Evaluierung von Lebererkrankungen. Trotz Fortschritte der Gerätetechnologie ist die sonografische Diagnostik diffuser Lebererkrankungen schwierig. Dies liegt auch an den häufig nicht oder nur unspezifisch nachweisbaren Veränderungen der Leber. Erfassbare Veränderungen beinhalten die Lebergröße, Leberform, Echogenität, Analyse von intrahepatischen Gefäßen sowie die Beurteilung von perihepatischen Strukturen und Lymphknoten. Die häufig nur schwer zu erkennenden Veränderungen des Leberparenchyms wurden bisher kaum beschrieben. Aber auch bei selteneren diffusen Lebererkrankungen können typische sonografische Befunde erhoben werden. Die vorliegende Arbeit ist eine Literaturübersicht zu seltenen diffusen Lebererkrankungen und erläutert charakteristische sonomorphologische Befunde der einzelnen Krankheitsbilder.

Schlüsselwörter

Leitlinien - Morbus Wilson - Schistosomiasis - PSC - PBC - Virushepatitis - Autoimmunhepatitis

Key words

guidelines - Wilson’s disease - schistosomiasis - PSC - PBC - viral hepatitis - autoimmune hepatitis

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