Liver Ultrasound Procedure

Patient Positioning

• Position: Supine
• Legs: Bent to relax abdominal muscles
• Arms: Above head to expose ribs

Probe Placement

• Starting Point: 9th or 10th rib space, mid-axillary line
• Probe Types: Phased array or curvilinear
• Indicator Direction: Towards patient’s head
• Screen Indicator: Left side of the screen

Scanning Process

1. Initial Placement: Place probe on 9th or 10th intercostal space
2. Identify Structures: Increase gain to view liver
   • Superior to Inferior Structures:
     • Lung: Most superior, shows mirror artifact (normal)
     • Diaphragm: Hyperchoic (bright structure)
     • Liver: Appears grayish
     • Kidney: Right kidney below liver
     • Morrison's Pouch: Area between liver and right kidney
       • Potential accumulation of free fluid or ascites/blood

Important Considerations

• Liver Tip: Scan towards the liver tip for free fluid
• Hepatomegaly Detection: Measure from diaphragm top to liver edge
• Echogenicity of Liver:
  • Bright: Indicates chronic scarring or cirrhosis
  • Dark: Indicates hepatitis due to fluid and inflammation