Normal vs Abnormal Liver Ultrasound - What Does It Show?

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Medically Reviewed by Dr. Aman Priya Khanna
Written by Rajath R Prabhu, last updated on 7 December 2022
Normal vs Abnormal Liver Ultrasound - What Does It Show?

Liver ultrasounds are a standard non-invasive diagnostic method for medical diagnosis. It is performed to check for liver abnormalities.

Liver ultrasound can give normal or abnormal results--normal liver ultrasounds show no signs of damage or disease, while abnormal liver ultrasound images can indicate injury or illness.

Analysing normal vs abnormal liver ultrasound helps monitor the results to understand the progression of a disease or the liver's health.

What is an Ultrasound?

In an ultrasound test, images of internal organs are created using high-frequency sound waves. When an ultrasound of the liver is done, the sonographer can observe the image of a person's liver and blood vessels.

Need for an ultrasound of the liver

A healthcare consultant may suggest an ultrasound of the patient's liver when they suspect any damage. After evaluating various symptoms and the patient's history, the doctor might decide to carry out an ultrasound.

Some of the reasons that require an ultrasound include the following:

  1. When you suffer from unexplained pain in the upper right of the abdomen.
  2. When you exhibit symptoms associated with an enlarged liver.
  3. To review the progress of a treatment that you undergo for any liver condition.
  4. To check for liver cancer, hepatitis, or cirrhosis.
  5. To prevent lesions such as liver tumours, abscesses, or cysts.

While these are the significant reasons a doctor might suggest you undergo an ultrasound test, other causes may depend on the patient's particular health conditions.

How to prepare for an ultrasound of the liver?

Before undergoing a liver ultrasound, you may be given specific instructions to follow. These may include the following:

  1. Avoid drinking or eating anything for 8 hours before the test.
  2. Wear loose and comfortable clothes.
  3. Do not wear jewellery or carry any credit or debit cards with you.

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Normal vs Abnormal Liver Ultrasound Results

Ultrasound results can vary according to the conditions of the liver, based on which one may get normal or abnormal liver ultrasound results. Let's try to dissect normal vs abnormal liver ultrasound results in detail here:

Normal liver ultrasound

  1. A normal ultrasound will show a smooth, uniform liver with no masses or lesions. The liver's size, shape, and texture should all be normal.
  2. A normal liver ultrasound indicates that the patient has no visible health issues with the organ.
  3. However, the doctor may decide if you must undergo further tests if they suspect other issues.

Abnormal liver ultrasound

An abnormal liver ultrasound shows signs of damage or disease of the organ. There may be a range of reasons for an abnormal ultrasound. When the test returns abnormal liver ultrasound images, the medical professional looks at the following to understand any health issues with the liver.

  1. Inflammation: Unlike a normal ultrasound, an abnormal liver ultrasound would show if there is inflammation in your liver caused by viral or parasitic infection. This can further reduce the organ's function.
  2. Liver size changes: An unhealthy liver would mostly show differences in size. The ultrasound would pick these size changes in the test, such as an enlarged liver, which may be caused by other diseases such as cirrhosis, cancer, etc.
  3. Fat deposits in the liver are shown when normal vs abnormal liver ultrasound results are analysed. This may indicate fatty or enlarged liver, which may be caused by other serious problems such as cancer, cirrhosis, fibrosis, etc.
  4. Scarring or fibrosis: Unlike a normal liver ultrasound, an abnormal liver ultrasound will show scarring or fibrosis. These symptoms indicate hidden or undetected diseases, such as Liver cirrhosis, an enlarged liver, etc.
  5. Lesions and growths: All lesions and changes in your liver, such as abscesses, cysts, tumours, bile duct cancer, etc., would be identified in an abnormal ultrasound result.
  6. Blockages: In adults and biliary atresia in infants, gallstones, sludge, etc., can cause liver blockages, which are observed in an abnormal liver ultrasound image.
  7. Bile duct changes: An abnormal liver ultrasound shows changes, such as inflammation, swelling, etc., in the bile ducts leading to the liver. If such changes are not identified and treated, they could lead to biliary cirrhosis.

What does an abnormal liver ultrasound mean?

A liver ultrasound is not a binary test that produces a yes/no or positive/negative answer. Instead, it uses sound waves to visualise the liver, blood vessels, and associated structures such as the gallbladder. The meaning of an abnormal liver test depends on what a doctor finds. In most cases, abnormal results will require additional testing.

Most of the time, an abnormal liver ultrasound would lead to the diagnosis of one or more of the following:

  1. Scarring: Also called fibrosis or cirrhosis, scarring happens when scar tissues grow in the liver. It is also a symptom of long-term liver damage that went untreated. One must also remember that scarring is impossible to reverse, though its further progress can be limited.
  2. Ascites: Ascites are the building up of fluid in a person's abdominal area due to the liver starting to malfunction. It is also one of the most apparent indications of cirrhosis. This is one of the most identifiable conditions when looking at normal vs abnormal liver ultrasound results.
  3. Liver nodules and growths: Many conditions may indicate liver nodules and growths, such as abscesses, cysts, tumours, bile duct cancer, etc. These can be a sign of cancer developing in the person's liver or cancer from other organs or body parts spreading to the liver.
  4. Fatty liver or hepatomegaly: Hepatomegaly, or an enlarged liver, is a condition when the size of a person's liver increases abnormally for various reasons. The causes could be anything from hepatitis, steatosis, and amyloidosis to conditions related to ageing and poor eating habits.
  5. Alcohol-related liver damage: Many alcohol-related liver damages can be determined by analysing normal vs abnormal liver ultrasound results, such as cirrhosis, a fatty liver, etc.
  6. Gallstones: Although the gallbladder is not a part of the liver, damage to the gallbladder can affect it too. Sometimes, digestive liquid can harden, take a stone-like shape, and get deposited in the bile duct. This can cause severe pain and excess secretion of liver enzymes.
  7. Liver failure: It can occur either suddenly or over a while. Liver failure may happen due to various conditions, such as Liver hepatitis, excessive alcohol use, taking acetaminophen in high doses, or advanced cases of an enlarged liver. Comparing the normal vs abnormal liver ultrasound images can help a medical professional determine the same.
  8. Biliary atresia: A rare disease in infants, biliary atresia occurs when the bile ducts become swollen, and the flow of the bile fluid is blocked in the duct at the liver. This can cause the liver's cells to wither, resulting in cirrhosis. The symptoms of this condition are jaundice, yellow eyes and yellowing of the skin.

What to do after getting an abnormal liver ultrasound?

When your medical advisor finds out that you can have specific issues with your liver after analysing the normal vs abnormal liver ultrasound results, further treatment may be charted based on the condition.

Since ultrasound is not a definitive guide to determining the disease and a path to finding out what is wrong with the liver by looking at the abnormal liver ultrasound images, further diagnosis may be needed.

Additional testing

After the examination of the results of comparing liver ultrasound images to understand normal vs abnormal liver conditions, further testing may be advised.

Some of the tests that are generally preferred are:

A liver biopsy: A liver biopsy is the biopsy of a person's liver after it has been tested for abnormality. It is suggested by medical professionals when certain liver diseases or conditions are identified. The biopsy helps doctors accurately identify the problem and determine the treatment course.

Liver functional tests: Functional tests help measure different types of proteins, enzymes, and substances secreted by the liver. These tests are essential in checking the condition of the liver after an abnormal ultrasound.

Some of the standard liver function tests are:

  1. ALT or alanine transaminase test
  2. AST or aspartate aminotransferase test
  3. ALP or alkaline phosphate test
  4. Albumin test
  5. Bilirubin test

Treatment

After the previous stages of diagnosis and tests, the following treatments are advised by the doctor based on the abnormal liver ultrasound and other tests. A suitable treatment pathway is suggested depending on the conditions and diagnostic results.

  1. Surgery: If the liver ultrasound's normal vs abnormal results combined with other tests suggest that there are gallstones or other blockages in the bile ducts, surgery is needed.
  2. Antiviral drug treatments: When the diagnosis and examinations suggest that the patient has any viral hepatitis, adequate antiviral drug treatment is recommended.
  3. Cancer treatments: If the tests discover any malign growth, cysts, tumours, or other kinds of cancer, treatments for the tumour are sought. It could range from chemotherapy to radiation and surgery.
  4. Counselling and treatments for alcoholism: In patients who are suffering from liver disease due to excessive alcohol consumption, apart from treating liver conditions, counselling and treatments for alcohol abuse are suggested.
  5. Lifestyle changes: The doctors advise changes in conditions such as enlarged liver, cirrhosis, alcohol-induced damage, etc. The most important thing is maintaining a healthy diet. Avoid junk foods, sugar, salt, and high-cholesterol foods and eat more fruits, vegetables, etc. Building a habit of daily exercise and making a few lifestyle changes, such as avoiding alcohol consumption, smoking, etc., are also advised.
  6. Liver monitoring: Here, the doctor might suggest further continued monitoring of the conditions and other diseases related to the liver to understand the progress of the treatment as well as the ailments of the liver. This helps the doctors adjust the treatment or chart a new course of treatment.

Takeaway

Ultrasound is one of the best ways to discover the signs of liver damage and diseases. While ultrasound may not give you a clear idea about the condition, it would suggest the path you need to take for a more evident diagnosis. When the liver ultrasound images in normal vs abnormal tests are evaluated, it can quickly identify most liver damage. The faster the diagnosis is, the better your chances of curing the disease.

While seeking help with ultrasound, you must work with professionals with the right experience and expertise in the medical field. HexaHealth can be of great help to you in this regard. A unique and expansive healthcare platform, HexaHealth brings together medical professionals, institutes, and other allied service providers under the same umbrella to help people looking for professional medical care and help from qualified and established medical practitioners.

Frequently Asked Questions

What does an abnormal liver ultrasound mean?

An abnormal liver ultrasound means that the liver may suffer from one or more health conditions, such as fibrosis, cancer, tumour, gallstones, or alcohol-related issues.

How do you know if your liver is abnormal?

When a medical practitioner assesses the images from the liver ultrasound in normal vs abnormal conditions, certain signs or indications may be noticed, such as changes in size, fat deposits, scarring, blockages, etc. These conditions suggest that your liver is abnormal.

What is a normal liver ultrasound?

A normal ultrasound would return images of your liver and observe no signs of abnormalities.

Can ultrasound detect liver problems?

Yes, liver problems can be detected by an ultrasound. A straightforward comparison between liver ultrasound normal and abnormal images can tell you if there are any serious problems.

What do abnormal liver cells mean?

It means that your liver suffers from infections, allergies to medications, etc., which can lead to inflamed or injured liver cells secreting more than normal chemicals and enzymes into the bloodstream. 

What could cause abnormal liver results?

Fibrosis, cancer, tumour, fatty liver, gallstones, or alcohol-related issues, can cause abnormal liver results.

Is abnormal liver function serious?

It can sometimes be severe depending upon the disease that causes an abnormal liver. Some conditions can be treated and recovered from if identified early and treated, while others may not be reversible. However, further worsening of the issues can be prevented by timely treatments.

What does a liver ultrasound show?

A liver ultrasound can show inflammation, size changes, fat deposits, scarring or fibrosis, lesions and growths, blockages, bile duct changes, etc.

How accurate is an ultrasound for the liver?

Although an ultrasound image of your liver can show signs of disease and liver damage, ultrasound cannot be used alone to determine the disease. Your doctor may need additional tests, examinations, and observation to finalise liver conditions.

Is fatty liver visible on ultrasound?

Yes, fatty liver is visible on an ultrasound image. However, your doctor may need further examinations and diagnosis to determine its severity and adequate treatment plans.

Does ultrasound show liver cirrhosis?

Yes, ultrasound can show cirrhosis. However, further examinations and diagnosis may be needed to determine its severity and adopt adequate treatment plans.

What does liver failure look like on ultrasound?

On an ultrasound image, steatotic livers appear brighter, whereas the normal appearance is darker. At the same time, cirrhotic livers can be seen as skinny and lumpy on the ultrasound image.

How accurate are liver ultrasounds?

Ultrasounds accurately show various liver conditions, such as fibrosis, cancers and tumours, enlarged liver, gallstones, or alcohol-related issues.

Can a liver ultrasound detect cancer?

Yes, it can. Often, ultrasound is the first and most preferred test to diagnose liver cancers. An ultrasound shows tumours, cysts, lesions, and growth in the liver and can adopt further testing to finalise the diagnosis.

Updated on : 7 December 2022

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

Author

Rajath R Prabhu

Rajath R Prabhu

MSc. Clinical Research I PG Diploma in Public Health Services Management

3 Years Experience

His work in medical content writing and proofreading is noteworthy. He has also contributed immensely to public health research and has authored four scientific manuscripts in international journals. He was assoc...View More

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