Liver pathology -diffuse liver disease Criteria for analysing diffuse liver disease include evaluation of liver parenchyma(echo texture, ultrasound attenuation, vascular architecture, etc.)as well as its surface (a high frequency transducer is helpful in detecting more details of the superficially located structures); liver hilum structures including perihepatic lymph nodes in the hepatoduodenal gament, lymph nodes in liver disease or neoplastic infiltration; analysis of hepatic vessel flow patterns using colour and pulsed wave Doppler imaging(CDi) Ultrasound contrast agents(USCA)have improved the detection/exclusion rate of focal liver lesions; in diffuse liver disease, USCA potential is much lower(e.g hepatic transit time Hepatic steatosis Hepatic steatosis is the most common liver pathology. Sensitivity and specificity of the detection of hepatic steatosis by B-mode ultrasound examination may be very high in the hands of an expert investigator who consistently applies specific criteria in patients with significant fatty liver disease. In transabdominal ultrasound, hepatic steatosis is characterised by increased echogenicity, which is often compared to the spleen or kidney parenchyma at the same depth [Figure 6]. Supporting findings may be ultrasound attenuation, which means a decrease in intensity as sound travels hrough a material, caused by absorption, scattering, and beam divergence Attenuation decreases detail analysis of vascular architecture, and it may cause a loss of visibility deeper within the liver and impeded imaging of the diaphragm Figure 6 Hepatic steatosis(fatty liver). Sonographic signs of hepatic steatosis include hepatomegaly with rounded borders, increased echogenicity, ultrasound attenuation caused by absorption, scattering, and beam divergence and decreased detail display of intra-hepatic vascular architecture. There is exageration of the difference between the kidney parenchyma and liver echogenicity. Right kidney is shown between callipers(+) In the majority of patients with hepatic steatosis, distinctive hypoechoic areas in the liver hilum can be demonstrated by ultrasound examination [Figure 7][7; 28 38)].ItLiver pathology - diffuse liver disease Criteria for analysing diffuse liver disease include evaluation of - liver parenchyma (echo texture, ultrasound attenuation, vascular architecture, etc.) as well as its surface (a high frequency transducer is helpful in detecting more details of the superficially located structures); - liver hilum structures including perihepatic lymph nodes in the hepatoduodenal ligament, lymph nodes in inflammatory liver disease or neoplastic infiltration; - analysis of hepatic vessel flow patterns using colour and pulsed wave Doppler imaging (CDI). Ultrasound contrast agents (USCA) have improved the detection/exclusion rate of focal liver lesions; in diffuse liver disease, USCA potential is much lower (e.g., hepatic transit time). Hepatic steatosis Hepatic steatosis is the most common liver pathology. Sensitivity and specificity of the detection of hepatic steatosis by B-mode ultrasound examination may be very high in the hands of an expert investigator who consistently applies specific criteria in patients with significant fatty liver disease. In transabdominal ultrasound, hepatic steatosis is characterised by increased echogenicity, which is often compared to the spleen or kidney parenchyma at the same depth [Figure 6]. Supporting findings may be ultrasound attenuation, which means a decrease in intensity as sound travels through a material, caused by absorption, scattering, and beam divergence. Attenuation decreases detail analysis of vascular architecture, and it may cause a loss of visibility deeper within the liver and impeded imaging of the diaphragm. Figure 6 Hepatic steatosis (fatty liver). Sonographic signs of hepatic steatosis include hepatomegaly with rounded borders, increased echogenicity, ultrasound attenuation caused by absorption, scattering, and beam divergence and decreased detail display of intra-hepatic vascular architecture. There is exageration of the difference between the kidney parenchyma and liver echogenicity. Right kidney is shown between callipers (+). In the majority of patients with hepatic steatosis, distinctive hypoechoic areas in the liver hilum can be demonstrated by ultrasound examination [Figure 7] [(7;28;38)]. It