A liver ultrasound is a procedure that uses sound waves to create images of your liver. It can capture your liver’s size, shape, and blood flow.

A doctor may recommend this noninvasive procedure if blood tests or symptoms suggest that you have a liver condition. They may also order an ultrasound to monitor an ongoing liver condition.

Abnormal ultrasound results may lead to a diagnosis or indicate the need for other tests.

What to ask your doctor before having a liver ultrasound

If your doctor recommends a liver ultrasound, you can ask questions to better understand the reasoning behind it.

You can ask your doctor what condition they suspect you may have, what the process will be like, and when you’ll hear about the results. You may also want to ask about potential follow-up tests if the ultrasound reveals anything atypical.

Your doctor might order an ultrasound if you have symptoms that suggest a liver condition. An abnormal ultrasound may show signs of the following conditions:

Fatty liver

Fatty liver disease falls into two categories. Nonalcoholic fatty liver disease occurs when your metabolism does not function as it should. Alcoholic fatty liver disease occurs as a result of consuming too much alcohol over an extended period.

Sometimes, fatty liver disease can also occur as a result of another condition or factor, such as hepatitis, medication use, or pregnancy.

This condition requires diagnosis and treatment to prevent it from getting worse. An ultrasound can detect fat on the liver and help your doctor diagnose your case as mild, moderate, or severe. Untreated fatty liver disease can lead to liver swelling, scarring, and even the death of liver cells.

Scarring

An ultrasound may indicate scarring on the liver. The early stage of scarring is called fibrosis. A more advanced stage is called cirrhosis. Scarring can be caused by fatty liver disease, excessive alcohol consumption, or hepatitis.

Scarring affects the way blood flows in your liver and can lead to liver failure or liver cancer if left undiagnosed and untreated. It may also make you more susceptible to infections and cause you to develop:

Liver nodules and growths

An ultrasound may detect growths on your liver. Some may be cysts or other benign masses. Others may be cancerous and invasive. Growths or other unusual spots on your liver may occur if you have another liver condition, such as hepatitis or cirrhosis.

Gallstones

A liver ultrasound may detect gallstones. These occur in your gallbladder, which is next to your liver. This organ holds and releases bile, a substance that helps break down food. Gallstones are hard masses that are very painful and can affect your:

Hepatomegaly

Hepatomegaly is a condition in which the liver becomes enlarged. A variety of underlying conditions can cause this, such as:

Alcohol-related liver damage

Drinking alcohol excessively for an extended time can affect your liver in several ways. You may develop one or more liver conditions, such as fatty liver disease, liver scarring, or liver cancer. These can lead to liver failure and possibly even death.

It’s important for a healthcare professional to diagnose and treat any alcohol-related liver conditions as early as possible to prevent them from getting worse.

A liver ultrasound will allow your doctor to see the size, shape, and texture of your liver. This view can give them an inside look at your liver and help them find out whether anything atypical is going on.

Typical results

An ultrasound with typical results will show a liver that:

  • is the expected shape and size
  • looks uniform
  • has no extra fat
  • is free of scarring, growths, and lesions
  • has no blockages in the veins or ducts

Additionally, a typical ultrasound will not show signs of gallstones or other obstructions to the gallbladder.

Atypical results

Atypical liver ultrasound results may include:

  • changes to the size of the liver
  • extra fat deposits on the liver
  • lesions or nodules on the liver
  • scarring on the liver
  • blockages to the gallbladder or bile duct
  • blockages in veins or ducts
  • swelling

An abnormal liver ultrasound result will likely require some follow-up tests to help your doctor diagnose an underlying condition. Then, your doctor will decide whether your condition needs monitoring or treatment.

More testing

After an abnormal liver ultrasound, your doctor may want to order a variety of other tests to find out more about your liver. The tests they choose will depend on your specific ultrasound results.

Doctors may use blood tests to look for certain markers that indicate conditions related to the liver.

CT scans and MRIs can give your doctor a more detailed view of your liver than an ultrasound. CT scans use X-rays, while MRIs rely on radio waves and magnets. MRIs are more detailed than CT scans and can detect mild forms of fatty liver disease and even distinguish noncancerous tumors from cancerous ones.

You may need a contrast or doppler ultrasound if you cannot get a CT scan. This is another type of ultrasound in which a technician administers dye into your liver to capture how your blood flows through it.

A test called an elastography may be useful as a follow-up. This test uses either ultrasound or MRI technology to look at how elastic the liver is. A doctor can use this test to gather information related to fatty liver disease and fibrosis.

A liver biopsy is the most invasive type of test, but it offers a lot of useful information to your doctor. A doctor will use a needle to remove a piece of tissue from your liver and view it under a microscope.

Monitoring

Your doctor may determine that your condition requires regular monitoring. You may need additional ultrasounds or other tests to keep track of your condition over time. You may also need ongoing monitoring if you’ve had a liver transplant.

Treatment

Treatment will vary based on your condition, its severity, and its underlying cause.

Some treatment plans will help you manage symptoms, while others will aim to cure a certain condition.

Your doctor may recommend strategies such as:

You may also need medications or more extensive treatments for liver conditions, such as:

Here are some frequently asked questions about liver ultrasounds.

Does liver damage show up on an ultrasound?

An ultrasound can show some liver damage, though it’s not the most sensitive type of test. A doctor may order additional testing if anything looks atypical on the ultrasound.

What liver conditions show up in a liver ultrasound?

A liver ultrasound may be able to detect conditions such as fatty liver disease, growths on the liver, scarring, and gallbladder stones.

Should you get a second opinion on liver ultrasound findings?

Getting a second opinion on your ultrasound findings is a personal choice. You can ask your doctor any questions you have to better understand your results and then seek a second opinion if you do not feel satisfied with their diagnosis.

Liver ultrasounds can detect many health conditions. A doctor may order an ultrasound if they suspect that you have a liver condition.

Your ultrasound may show signs of a liver condition, or your doctor may order further testing to help them make a proper diagnosis. Talk with your doctor if you have any questions or concerns before or after a liver ultrasound.