Sonography of the liver, gallbladder, and spleen

Focal hepatic and splenic lesions, vascular abnormalities, and disorders of the biliary system can readily be detected with ultrasonography. The sonographic appearance in certain cases may be nonspecific, but the differential diagnosis can be substantially narrowed when the presenting clinical signs are considered. Ultrasonography is less helpful when the liver or spleen is diffusely involved without parenchymal abnormalities. However, certain diseases may also be eliminated from diagnostic consideration on the basis of this finding. Percutaneous ultrasound guided biopsy markedly improves the success and safety of obtaining a definitive diagnosis when either diffuse or focal lesions are present. Sonography has also been very beneficial for serially evaluating the response to therapy once focal lesions of the liver or spleen have been identified.