The liver is located in the upper right part of the abdomen and plays a central role in all metabolic processes in the body. It helps to maintain a normal glucose level in the blood. When the blood sugar is low the liver breaks stored glycogen and triglycerides down to glucose to release into the blood stream. The liver also helps to utilise protein, fat and carbohydrates that comes with food. It produces the bile that breaks down fats and converts it to ATP (energy source) and stores substances such as glycogen, iron and vitamins which are essential for metabolism 😁 The liver makes almost all plasma proteins used in immune and coagulation systems, and one of its main roles is detoxification 🙌 The liver processes almost all substances that enter the body by breaking it down and excreting toxins.
The NAFLD prevalence was reported as 83% in extremely obese adolescents . In the current study, pathological liver echogenicity was present in 44% (n = 458) of the patients in our study population. 71% (n = 327) of the patients in our extremely obese group were affected by increased liver echogenicity. Elevated liver enzymes > 25 U/L were found in 64% (n = 664) of all children and adolescents. Out of these patients, the extremely obese group accounted for 65% (n = 439) of the cases. Elevated liver enzymes > 50 U/L were detected in 17% (n = 174) in our study population. In the extremely obese group, increased liver enzymes > 50 U/L were observed in 75% (n = 131). Fat infiltration must affect > 20% of hepatocytes to be visualized by liver ultrasound . In NAFLD, literature reports a strong correlation between liver echogenicity and liver biopsy. Therefore, ultrasonography can be postulated as an easily, available, feasible and safe screening method . (thank you to Jaret Cotton from Linfen, China for bringing this to our attention).
Isis Craft at revespcardiol.org, explains how a solid nodule can be hyperechogenic, isoechogenic or hypoechogenic with respect to the adjacent parenchyma, it can be homogeneous or heterogeneous, and flow may be detected in the Doppler study, although a negative result does not rule out a solid lesion. If a solid nodule is detected, it should be compared with any previous studies that may be available to evaluate whether it is a new nodule, is stable, or has grown, and it should be correlated with the patient’s medical history (eg, history of tumourss, hepatitis B or C virus infection, alcoholic cirrhosis) for a decision to be made on the performance of any additional imaging tests. (emended by Hannah Barter from Grande Vitoria, Brazil on October 17, 2020)
They may describe whether a particular lesion is darker than (hypoechoic), similar to (isoechoic), or brighter than (echogenic) background liver tissue. Margins of the lesion are often described (smooth, irregular, etc) as well as any visible blood flow within the lesion on Doppler ultrasound, if performed. The presence of any abnormal enlargement (dilatation) of bile ducts in or outside the liver will be reported, along with any abnormal fluid (ascites or fluid collection) next to the liver. Other organs or portions of them can also be seen while scanning the liver, and a patient may see gallbladder or kidney stones (calculi) reported.