Content Content Topographic Remarks Liver anatomy Ultrasound Examination technique Patient Preparation Examination Liver pathology -diffuse liver disease 8 Hepatic steatosis Liver cirrhosis Chronic viral hepatitis C Primary biliary cirrhosis(PBC) Doppler ultrasound techniques in the evaluation of liver disease Anatomy, blood supply of hepatic vessels Arterial flow 12 Portal venous system Venous outflow Vascular(Doppler) indices 13 Examination of the portal vein in patients with diffuse liver disease 13 Normal and pathological portal venous blood flow Portal hypertension No portal venous blood flow 14 Retrograde portal venous blood flow 14 Portal vein thrombosis Examination of the hepatic veins in patients with diffuse liver disease Hepatic venous outflow obstruction(Budd Chiari-syndrome, BCS) Liver pathology -detection and characterisation of focal liver lesions(FLL) Liver tumour detection .17 Differentiation of benign and malignant lesions Focal liver lesion(liver tumour)characterisation 19 L Haemangioma Hepatocellular carcinoma(HCC) Metastase Abscess Clinical importance of liver ultrasound in daily routine ReferencesContent Content........................................................................................................................1 Topographic Remarks......................................................... ........................................2 Liver anatomy..............................................................................................................3 Ultrasound Examination technique..............................................................................4 Patient Preparation...................................................................................................4 Examination.............................................................................................................4 Liver pathology - diffuse liver disease...................................................................... ..8 Hepatic steatosis......................................................................................................8 Liver cirrhosis......................................................................................................... 9 Chronic viral hepatitis C......................................................................................... 10 Primary biliary cirrhosis (PBC)...............................................................................10 Doppler ultrasound techniques in the evaluation of liver disease................................11 Anatomy, blood supply of hepatic vessels............................................................ . 11 Arterial flow........................................................................................................12 Portal venous system...........................................................................................12 Venous outflow............................................................................................ ..... .13 Vascular (Doppler) indices.......................................................................... .. ... 13 Examination of the portal vein in patients with diffuse liver disease.............. . ..13 Normal and pathological portal venous blood flow................................... ... ... 13 Portal hypertension..............................................................................................14 No portal venous blood flow................................................................................14 Retrograde portal venous blood flow...................................................................14 Portal vein thrombosis..........................................................................................15 Examination of the hepatic veins in patients with diffuse liver disease...................16 Hepatic venous outflow obstruction (Budd Chiari-syndrome, BCS).............. ....16 Liver pathology - detection and characterisation of focal liver lesions (FLL).............16 Liver tumour detection.................................................................................... ........17 Differentiation of benign and malignant lesions......................................... ............18 Focal liver lesion (liver tumour) characterisation....................................................19 Liver cyst..............................................................................................................18 Haemangioma.......................................................................................................19 Hepatocellular carcinoma (HCC)........................................................................ 20 Metastases............................................................................................................21 Abscess.................................................................................................................21 Clinical importance of liver ultrasound in daily routine........................................... ..24 References....................................................................................................................25