Measurement in Ultrasound

Paul S. Sidhu, Wui K. Chong, Keshthra Satchithananda, Paul S. Sidhu, Wui K. Chong, Keshthra Satchithananda

• Publisher: CRC Press
• Year: 2017
• Print ISBN: 9781138474048
• eBook ISBN: 9781315355917
• Edition: 2
• Topic: Medicine
• Subtopic: Anatomy

Measurement and interpretation of key ultrasound parameters are essential to differentiate normal anatomy from pathology. By using Measurement in Ultrasound, trainee radiologists and ultrasonographers can gain an appreciation of such measurements, while practitioners can use it as a valuable reference in the clinical setting.

The book follows a consistent format throughout for ease of reference and features useful information on preparation and positioning of the patient for ultrasound, the type of transducer and method to be used, the appearance of the resulting ultrasound images and the measurements to be derived from them.

Designed for frequent use in everyday practice, the book includes more than 150 high-quality ultrasound images annotated with key measurements and accompanied by concise explanatory text. Normal variants are provided, along with ranges for features that can change during development and in disease.

This new edition covers relevant developments in ultrasound. Where appropriate, updated ultrasound measurements that have arisen are also included and key references are provided as an aid to further study.

1 Upper Abdominal

Anu E. Obaro, Venus
Hedayati, Colin R. Deane,
Keshthra Satchithananda and
Paul S. Sidhu

Liver

Liver size

Liver fibrosis assessment

Biliary tree

Gallbladder and gallbladder wall

Spleen

Pancreas

Pancreatic duct (adult)

Adrenal glands (adult)

Diaphragm

Upper Abdominal Vasculature

Portal vein

Hepatic veins

Hepatic artery

Celiac and superior mesenteric arteries

Doppler ultrasound assessment of post-prandial intestinal blood flow

Inferior mesenteric artery

Liver size

Preparation

None.

Position

Supine, right anterior oblique to demonstrate the porta hepatis.

Transducer

2.0–6.0 MHz curvilinear transducer.

Method

Longitudinal views are taken in the midclavicular and midline positions, and measurements obtained. Anteroposterior diameters are also measured at the midpoint of the longitudinal diameters. All measurements are taken on deep inspiration.

Appearance

Uniform pattern of medium-strength echoes.

Measurements

There are significant variations in liver size due to gender, age, body mass index and weight.

Diameter	Female cm (mean ± SD)	Male cm (mean ± SD)
Midclavicular line (largest craniocaudal diameter)	14.9 ± 1.6	15.1 ± 1.5

In the transverse plane, the normal caudate lobe should be less than 2/3 of the size of the right lobe.

A midline longitudinal view through the left lobe of the liver, demonstrating the anteroposterior diameter (AP) and the midline longitudinal length (ML).

A midclavicular longitudinal view through the right lobe of the liver, with a midclavicular anteroposterior diameter (MAP) and a midclavicular longitudinal length (MCL).

Further Reading

Kratzer W., Fritz V., Mason R.A., Haenle M.M., Kaechele V. Factors affecting liver size: A sonographic survey of 2080 subjects. J Ultrasound Med.2003; 22:1155–1161.

Patzak M, Porzner M, Oeztuerk S, Mason RA, Wilhelm M, Graeter

T, Kratzer W., Haenle M.M., Akinli A.S.. Assessment of liver size by ultrasonography. J Clin Ultrasound.2014; 42:399–404.

Liver fibrosis assessment

Preparation

Patient should fast for 6–8 hours prior to the examination.

Position

Supine, right anterior oblique.

Transducer

2.0–6.0 MHz curvilinear transducer.

Method

Measurements are obtained from an intercostal view, to interrogate an area of the liver at least 2 cm deep to the liver capsule, away from major vessels. The right arm is raised above the head. The sample box is placed over the area selected, ideally in a perpendicular position, and a total of 10 measurements are obtained in brief suspended respiration, from the same area of liver. Segments 5 and 6 are normally interrogated; the left lobe of the liver should be avoided. Different ultrasound machines have different methods of obtaining readings and different display methods, and the readings are not transferable between machines. Transient elastography (TE) or “fibroscan” and acoustic radiation force impulse (ARFI) imaging are the most commonly used methods. A fibroscan does not produce an ultrasound image, and provides measurements in kilopascals (kPa).

Appearance

The measurements can be expressed in velocity of shear wave (m/sec). The level of liver fibrosis is calculated and classified according to the METAVIR (F0–F4) or ISHAK (0–6) scoring system to ascertain normality, the degree of liver fibrosis, or the presence of cirrhosis. The most common diseases for which fibrosis will be assessed are Hepatitis C virus (HCV), Hepatitis B virus (HBV), and alcoholic liver disease.

Measurements

Acoustic radiation force impulse (ARFI) imaging
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Table of contents

• Cover Page
• Half title
• title
• copy
• fmchapter
• bio
• Adults
• 1 Upper Abdominal
• 2 URINARY TRACT
• 3 Organ Transplantation
• 4 Genital Tract
• 5 Gastrointestinal Tract
• 6 Superficial Structures
• 7 Peripheral Vascular (Arterial)
• 8 Peripheral Vascular (Venous)
• 9 Musculoskeletal System
• 10 UPPER ABDOMEN
• 11 Renal Tract
• 12 Pediatric Uterus, Ovary, and Testis
• 13 NEONATAL BRAIN
• Part Obstetrics
• 14 Obstetrics
• Index