GI Imaging - Hepatic Steatosis and Cirrhosis

Audience: Medical Students, Junior Radiology Residents, or GI Fellows
Learning Objectives:
Recognize and describe increased echogenicity of the liver associated with hepatic steatosis
Recognize and describe surface nodularity and coarsened hepatic echotexture associated with hepatic cirrhosis
Summary:
Steatosis
Accumulation of lipid in the hepatocytes
Most commonly detected in Non-alcoholic fatty liver disease and Alcohol liver disease
Detected as increase echogencity on ultrasound
Loss of distinct periportal fat
Increased echogencitiy compared to kidney
Cirrhosis
Development of fibrosis in the liver
Only apparent on ultrasound once severe
Coarsened echotexture
Surface nodularity

[@IvanHernandez-dj5fs]

This video was very helpful in helping me understand my liver ultrasound report. I will consult with my doctor but it’s nice to get a better understanding for myself of what all the terms in the report mean.

[@healer378]

Finally a good teacher. Thank you.

[@RadiologyEducation]

Glad it was helpful!

[@zhrahmad9291]

Thank you very much Sir .

[@RadiologyEducation]

Most welcome

[@FrankColesMadeEasy]

Good explanation. Clear, concise and precise. Thanks.

[@everyday316]

Excellent video. Thanks for posting

[@ellebee4373]

Watched with great interest as i had a liver US today. Thankyou!

[@mrshonestopinion]

This is the most useful and succinct video I have seen on liver ultrasound. Got straight to the point and really helped me a lot. Thanks a million.

[@ghulamrasul2699]

Thank you very much

[@izzygee2216]

Great video and explanation!

[@rajendrakumarsinghmehra2368]

Very helpful . Thanks

[@godspromiseinternationalmi1564]

Well simplified thanks a lot

[@user-pk9xs6fi8x]

Explained in a better way sir!

[@eirikdegard4498]

thank you! Very well presented.

[@rahaafzaly4149]

Very nice and informative

[@RadiologyEducation]

Thanks for liking

[@AnaMartinez-qq9li]

Super helpful. Thank you

[@godspromiseinternationalmi1564]

Continue posting more in pelvic ultrasound Scan

[@atuohaernest8626]

Thanks alot for the explanation... It really helped

[@aneshgovindnair2309]

really fantastic.

[@RadiologyEducation]

Glad you find the videos helpful

[@frank4282]

Thank you so much.

[@aidahoe2946]

My ultrasound states mild hepatic steatosis, is this serious?

[@Jerry-zx7rf]

mild diffuse increased echogenicity is seen throughout the liver consistent with fatty infiltration of the liver ? can it be cirrhosis what the chance of US missing Cirrhosis

[@uncivilisedpink]

I had to ultrasound that said echogenic and nodular texture. Normal size and shape. Does this always mean cirrhosis?

[@zohebmulla3670]

Sir colon ulcers can be seen in sonography?

[@gerriedoll154]

Can this illness be fix ??? What is the best dieet if you have this ??

[@kamakhyabiswas1175]

other parameters like volume redistribution were not described here.

[@RadiologyEducation]

That is an good point. I find that volume distribution is more difficult to assess on US than CT or MR, but that is not to say it cannot be done, and it is certainly relevant to any discussion on cirrhosis

[@t.ssirvigyandarshan8467]

Hello sir .... What is the accuracy of an ultrasound to detect Liver cirrhosis ... Can it be detected in its early stages by usg

[@drakegabrielvereto8423]

Any paper that backs that up? I could really use this for a part of my Uni project

[@RadiologyEducation]

This is a good primary source. It focuses on quantitive imaging, but the intro has references to non-quantitative articles. Han, Aiguo, et al. "Assessment of hepatic steatosis in nonalcoholic fatty liver disease by using quantitative US." Radiology 295.1 (2020): 106-113.

[@venkatraamudu]

Thank you Dr Owen ❤ Can you please let me know the basic difference between echogenicity and echotexture?

[@RadiologyEducation]

Echogenicity is how bright or dark a structure appears on US. The liver will become more echogenic as it becomes steatotic. Echotexture is how uniform the liver appears. The liver could be bright or echogenic without being coarse, and could be course without being bright (echogenic). The brightness or echogenicity reflects the amount of fat. The coarseness reflects the degree of fibrosis.

[@venkatraamudu]

@@RadiologyEducation Thank you so much😇

[@ghulamrasul2699]

Thank u very much

[@gauravdadhich2499]

I had my ultrasound report written as enlarged and bright in echotexture....does it mean fibrosis

[@erikkadiana]

Well bright would be related to the echogenicity. If your report didn’t mention course for texture, nodular appearance in the border or commonly dx with cirrhosis then no. Enlarged and bright livers indicates fatty liver

[@kamakhyabiswas1175]

of course not, just avoid fatty diet.

[@gauravdadhich2499]

@@kamakhyabiswas1175 Thanks, I avoided fatty diet from day1 since I got the report about fat being accumulated on my liver

[@ARMINK6969]

Gaurav sir are u fine now? Have you tested again?

[@gauravdadhich2499]

@@ARMINK6969 NO I haven't done any formal ultrasound yet but yes I'm fine now, Doctor prescribed me LIV 52 that is an ayurvedic medicine and by god grace it worked for me

[@Queenjess69]

Thank you for this video .im waiting for my referral for a ultrasound on my left breast , my liver and ovaries and im so scared

[@herusaleron6793]

really broke it down simply and to the point. love this video!

[@RadiologyEducation]

Glad you liked it!

[@vpasha11]

Could you please tell me what is diffuse coarse echo texture with irregular margins.liver is normal .no obvious focal lesion seen.No interahepatic biliary duct dilation.portal vein is normal in caliber and shows hepatopetal flow .Gall bladder is moderately distended .No e/o calculi or sludge seen in visualized lumen.GB wall is normal.CBD not dilated.and spleen is normal .please do reply🙏

[@vpasha11]

Beautifully explained

[@herusaleron6793]

@@vpasha11 i’m no doctor but from my limited knowledge it can indicate mild cholecystitis and mild scarring (cirrhosis) of liver.

[@vpasha11]

@@herusaleron6793 thanks but my GB is normal

[@zireal6890]

beautiful lectuuuressss, thank you soo much I'm a first year radiology resident and US is soo hard and no one teaches u properly, thank so much !!!

[@Dattikirankumar123]

Sir fattyliver hyperechoice nodles noted liver regenertive nodels?

[@ZumarKhan-vk7ct]

Great Nd clear way of imparting education. Sir can you give us a vid on how to measure size of liver

[@Dattikirankumar123]

Become dangerous sir

[@pianoworldastghiklevonyang2574]

Excellent video but anyone here can explain if I need to worry about my Ultrasound results Findings are: Liver is mildly heterogeneous and Echogenic and portal vein is patent. Any help will be greatly appreciated Thank you in advance

[@1945erde]

Can be initial stages of steatosis, presented as vague slight hyperechoic zones throughout the liver or just in one lobe or a part of a lobe, detected and confidently recognized by means of ultrasound?

[@MrTMrT007]

Good video for beginners

[@its-raga3704]

My moms ultra report is : liver normal in size no focal issue is seen.echotexture of liver parenchyma slightly coarse... So what we do???

[@fadi2010ida]

Thank you so much * very helpful video

[@RadiologyEducation]

Glad it was helpful!

[@m4mike250]

what is the meaning of "bright echotexture of liver"

[@gauravdadhich2499]

It simply means accumulation of fat upon your liver Avoid a fatty diet and do simple exercises, Yeah That's it

[@m4mike250]

@@gauravdadhich2499 but the report says the patient is suffering from grade-II fatty liver which is an irreversible health condition 🤔

[@gauravdadhich2499]

@@m4mike250 look condition is not irreversible if you follow some strict guidelines for your daily routine, it is just that you need to be disciplined no matter what's going on :) And believe me, there is a possibility that fat percentage doesn't decrease but you will surely feel the difference and one most important thing (I'm just telling neither I am a doctor nor you...don't be anxious after reading this out) is that your fat accumulation may increases if you don't follow certain daily routines...and that may lead to cirrhosis which is a serious liver problem and that is surely irreversible ...do you want to face cirrhosis? Of course not, right? then start following a daily routine not be attract beauty near you, but to remain fit through out your life I am waiting for the reply when you will say it helped for me .....I wish you'll be fine

[@yonisxasan8548]

What does congestion and shrink liver ultrasound mean

[@SimonPeter-ti8xd]

Great video

[@partymariner]

What does normal echogenicity mean? Is that bad?

[@RadiologyEducation]

That means it has a normal appearance on the Ultrasound. Echogenicity refers to how bright something is on the US image