A patient has a steatotic, echogenic liver, which prevents adequate penetration. What troubleshooting tips can improve visualization?  
Is it necessary to use a linear high-resolution transducer in all liver screening studies?



FAQ-124: A patient has a steatotic, echogenic liver, which prevents adequate penetration. What troubleshooting tips can improve visualization?

  

The following changes in instrumentation settings can improve visualization in some patients: lowering the transducer frequency, switching to a penetration mode or preset, turning off harmonics or changing spatial compounding settings. Patient related techniques that can improve visualization include varying patient position (left posterior oblique or left lateral decubitus), trying an intercostal approach, or having the patient suspend respiration at various points during a respiratory cycle.  


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FAQ-125: Is it necessary to use a linear high-resolution transducer in all liver screening studies?

While it may not be needed for HCC screening, or in known or established cirrhosis, it is frequently helpful in early or mild cases of cirrhosis to assess the surface contour to identify surface nodularity and heterogeneous echotexture which can help diagnose cirrhosis. A linear high-resolution transducer may also better visualize the superficial hepatic parenchyma and identify small tumors below the liver capsule. This technique is considered optional and can be utilized based on institutional preferences. 


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