How to choose ultrasound examination for patients with liver disease and understand the report of color Doppler ultrasound?

For patients with liver diseases, ultrasound examination is more frequent, but some people are confused about the examination results, intervals, purposes and significance. Here, the following points are for patients with liver disease to understand. 1. Normal liver is normal in size, symmetrical in shape and sharp in edge. Careful friends can observe the fresh pig liver, the edge is very thin and sharp. Then, once the liver gets sick and inflamed, the liver cells will swell. We observed with ultrasound that the first thing that appeared was the dullness of the hepatic margin, and the order was from the right hepatic margin to the left hepatic margin, and then to the whole hepatic margin. At this time, the liver is full in shape and the texture is like ground glass. In the ultrasound report, there will be a slight blunt circle or blunt circle at the liver margin. 2, long-term chronic inflammation, such as with the development of the disease, there will be liver cell degeneration, partial necrosis, proliferation, liver fibrosis and proliferative nodules, ultrasonic manifestations of uneven liver texture, showing small nodules, liver blood vessels become thinner and narrower due to proliferation and compression. In the report, the liver echo will increase and strengthen, and the distribution will be uneven or obviously uneven, and the pipeline structure will be unclear or unclear. 3. When a large number of liver cells are degenerated, necrotic and fibrotic, cirrhosis will gradually occur. At this time, the hepatic portal vein can be widened, which is normally less than 1.3cm and should be greater than 1.4cm, but comprehensive analysis is needed. 4. For patients with chronic liver disease, it is a long process from chronic hepatitis to ultrasound and other imaging standards to diagnose liver cirrhosis, some of which last for decades, and it is impossible to evaluate whether this period is chronic inflammation, fibrosis or early liver cirrhosis. Imaging diagnosis of liver cirrhosis has been advanced, such as liver atrophy, abnormal morphology, uneven surface, uneven texture, widened portal vein, enlarged spleen, open umbilical vein and portal hypertension. 5. Only liver biopsy can judge the severity of early cirrhosis, fibrosis or inflammation at cytological level. Before 1980s, the diagnosis of liver disease was mainly based on the jaundice degree of sclera, the size of touching the liver and the blood liver function. Sometimes the liver disease is so serious that it doesn't swell, but shrinks, so the hand can't touch it. Since then, with ultrasound and other imaging examinations, we can observe the size and shape of the liver, internal tissue texture and blood vessels, which has taken a big step, but if we want to understand the situation at the cellular level, we can only observe it with the help of a microscope, so liver biopsy is to observe diseases at the cellular and molecular levels. 6. Color Doppler ultrasound mainly observes the blood flow of hepatic vessels, whether there is reflux in portal vein and whether collateral circulation is unobstructed, such as umbilical vein, gastric coronary vein, gastric fundus vein, spleen and kidney vein, etc. As long as it is open, it means hepatic portal hypertension. Special attention should be paid to diet, and fish bones and chicken bones should not be eaten to prevent bleeding or even death caused by cutting esophageal veins. 7. Not all hepatitis cirrhosis must be hepatitis B and hepatitis C. In fact, there are many kinds of liver diseases, such as autoimmune liver disease, drug-induced liver disease and vascular liver disease, such as Budd-Chiari syndrome, blood stasis cirrhosis and alcoholic cirrhosis. 8. Chronic liver disease needs to be examined by ultrasound every three months. The first purpose is to understand the liver texture, and more importantly, to monitor the appearance of early liver cancer. 1-2cm can find early tiny hepatocellular carcinoma, which is of great significance for early treatment. 9, liver ultrasound routine examination, you can't wait for the pain in the liver area to check, because there are nerves in the liver capsule, but there is no innervation in the liver parenchyma, so only when the liver tumor grows big enough to stimulate the liver capsule, the liver area will feel pain, and at this time, the tumor is often very large, belonging to the advanced stage, and the treatment is particularly difficult and the curative effect is not good. If abnormal nodules are found in routine examination, it can be quickly determined whether it is liver cancer by contrast-enhanced ultrasound or even biopsy. Whether it is surgery or ablation, the curative effect of early micro-hepatocellular carcinoma is quite good, and it is common to survive for 5 or 8 years or even be completely cured. 10, doctors should be selected for liver examination. At present, ultrasound doctors are particularly hard and have many patients. They have to finish a lot of work in a short time in a dark room every day, but they are professional. Some doctors focus on heart disease, some on obstetrics and gynecology, some on blood vessels, some on abdomen, and some on interventional therapy. Be sure to choose an experienced ultrasound doctor in the liver to avoid misdiagnosis and missed diagnosis to the maximum extent.