ORGAN IDENTIFICATION .

USS-Cross-sectional anatomy of the liver, spleen, pancreas and kidneys

CROSS-SECTIONAL ANATOMY OF THE LIVER

Because of its size and location in the right upper quadrant, the liver is readily accessible to the ultra-sonographic transducer. The liver has 2 lobes, the right and left.The right lobe lies to the right of a line formed by the fossa of the gall-bladder and the sulcus of IVC. The left lobe is divided into medial(quadrate) and lateral segment.The right is divided into an anterior and posterior segment.

The liver is of homogeneous echogenicity, comparing the echo pattern of the right and left lobes to that of adjacent organs, such as the spleen, pancreas, and right kidney,is important. The normal liver is more echogenic than the renal cortex,slightly more echogenic than the spleen and slightly less echogenic than the pancreas The hepatic veins are visible as anechoic structures draining superiorly towards the IVC. .

NORMAL SONOGRAPHIC ANATOMY OF THE LIVER.

The portal vein lumen is also anechoic, but it has echogenic walls owing to surrounding connective tissue in the portal tracts. RPV-Right portal vein D- Diaphragm K- kidney

NORMAL SONOGRAPHIC APPEARANCES OF THE LIVER

The rt hepatic vein divides the rt lobe into anterior(AS) and posterior segment(PS). The left hepatic vein divides the left lobe into medial(MS) and Lateral(LS).

Sonographic appearances of the spleen

The spleen normally lies in the left upper quadrant of the abdomen between the 9th and 11th ribs. The long axis of the spleen is normally less than 13 cms some departments use 12 cms as their maximum length The normal splenic parenchyma displays a homogeneous pattern, which consists in the main of low level echoes. The splenic hilum, unlike the splenic substance, returns higher-level echoes.

The normal spleen is more echogenic than the adjacent kidney and slightly less echogenic than the liver.

Sonographic anatomy of the pancreas

The pancreas lies in the retroperitoneum in the anterior pararenal fascial space anterior to the aorta and inferior vena cava. It has 3 parts, the head, body and tail. They measure 3cm, 2cm, and 2.5cm respectively.

TRANSVERSE VIEW OF THE PANCREAS

Pancreas (p) shows a homogeneous texture, more echogenic than that of the liver L. The splenic vein (s) forms the dorsal border of the gland. ArrowheadSMA,A=aorta V=IVC

PANCREAS.
The pancreas (p) lies anterior to the superior mesenteric vein (s) and posterior to the stomach (st) and left lobe of liver (L). Arrow denotes the hepatic artery which has just branched off the celiac axis.

NORMAL PANCREAS SEEN ON TRAN SVERSE SCAN

visualization of the pancreatic duct (arrowhead) as a single line. Again are seen the stomach (st), left lobe of liver (L), aorta (a) and inferior vena cava (v). The fluid-fill

TRANSVERSE SCAN OF THE PANCREAS.

The pancreatic duct (arrow) is seen as a tube rather than a single echogenic line; as long as the internal diameter does not exceed 2-2.5 mm and the walls are parallel, this is still considered normal.

THE KIDNEYS

The echogenicity of the normal adult renal cortex is slightly less than or equal to that of the adjacent liver or spleen. The cortex should possess smooth lateral contours and should have a fairly uniform thickness throughout the kidney. The normal renal medullary pyramids are hypoechoic when compared to the cortex and are radially arranged around the renal sinus

The renal sinus, which contains fat, connective tissue, collecting system and vascular structures, is echogenic when compared to the cortical and medullary regions. The perinephric region is also typically echogenic. The renal pelvis and proximal ureter can be seen in the transverse plane of the renal midpole,

USS of the rt kidney