NORMAL- LIVER SCAN

• The normal liver parenchyma appears homogeneous.
•  Interrupted by the portal vein and its branches which are seen as linear tubular structures with reflective walls. 
• The thinner hepatic veins are non- reflective.
•   It should be possible to follow the hepatic veins to their confluence with the inferior vena cava. Hepatic veins can be made to dilate when the patient performs the Valsalva manoeuvre 
  
  
  

THE NORMAL LIVER SCAN

HEPATIC VEIN,PLEURAL EFFUSION

GB CAP,DEUDENUM

PV,CBD,IVC,AORTA,SV

WHAT SHOULD BE IDENTIFIED

• The vena cava may be seen in the liver and may vary with respiration.
•  The aorta may be identified as a pulsatile tubular structure behind and medial to the liver . 
• The falciform ligament will be seen as a hyperechogenic structrure just to the right of the midline in the transverse plane .
• It is also important to recognize the caudate lobe, limited posteriorly by the inferior vena cava and separated antero – superiorly from the left lobe of the liver .
• It is limited inferiorly by the proximal left portal vein. The caudate libe must be identified because it may be mistaken for a mass.
• The gallbladder and the right kidney must also be identified. 
• The pancreas and vertebral column should be identified. 
• The echogenicity of the normal liver parenchyma lies midway between that of the pancreas (more echogenic ) and the spleen (less echogenic).