Liver examination: a list of methods

If you began to notice the soreness in the right side, the taste of bitterness appeared in your mouth, often without cause you begin to feel sick, then chances are that these are problems with the liver. But do not start to guess on the coffee grounds and take advertised drugs. It is better to consult a specialist and perform a liver examination. Only after examining the results of tests, ultrasound, CT, MRI, radioisotope scanning or biopsy, can a correct treatment be prescribed.

General blood analysis

Usually the first step in examining the liver is tests. First and foremost, doctors always prescribe a general blood test. This is the simplest study, which does not indicate a specific problem, but will give an opportunity to determine the presence of inflammation of the organ. And if there is a decrease in platelet count, then we can assume viral hepatitis, as the work of liver cells is disrupted.

Biochemistry

You will have to donate blood from the vein, through which the liver enzymes (aspartate aminotransferase and alanine-amino transferase) will be determined. This analysis allows you to judge the damaged cell membranes that pass special cellular enzymes from the liver to the blood. The norm of these enzymes is less than 41 U / L ALT. If it is exceeded, it can be a sign of hepatitis of various forms. This analysis is called blood biochemistry. It allows you to determine the ratio of ALT, AST, identify alkaline phosphatase and determine the level of bilirubin, to estimate the concentration of gamma-glutamyl transferase (GGTP). The analysis determines more than 40 indicators.

Ultrasound

An important stage in the examination of the liver is ultrasound. Ultrasonic diagnosis allows you to determine the size of the liver and gallbladder. The method shows such diffuse changes as hepatosis, all kinds of pancreatitis, cirrhosis. So, for example, with hepatosis in the body will be visible blotches of fat cells. Hepatocytes and fat have different density, this means that the ultrasound image will look mottled. And as the disease develops, the liver cells will begin to be replaced by a connective tissue, and ultrasound will show signs of fibrosis.

As for focal changes, the examination of the liver with ultrasound clearly shows areas with increased density, which can be hemangioma, adenoma, metastasis of a cancerous tumor, calcifications. Also clearly the method allows to determine the reduced echogenicity of the sites, which may indicate the presence of sarcoma, lymphoma, abscess or hematoma.

Having studied the findings, the doctor will not be able to make an accurate diagnosis, but he determines the direction for further examination of the liver, excluding the rejected variants.

For the patient, such a study is completely painless. But minor training will be required, which excludes flatulence.

Computer scintigraphy and isotope scanning

Modern methods of examining the liver include radioisotope scanning or a more timely computer scintigraphy of the organ system, including the liver, gall bladder and ducts. The first method has been actively used in medical practice since the early 1960s and has lost some of its relevance. The second method appeared relatively recently and has already gained popularity among diagnosticians. The study allows to assess the degree of functioning of the body, determine its size, identify neoplasms and establish the presence of chronic processes.

Scintigraphy is performed using colloidal sulfur (or other organic matter), which is labeled with radioactive technetium 99. A radioactive isotope is administered to a patient intravenously or by inhalation. Then, using a gamma camera, the radiation is captured, converted and transferred to a computer. The image is layered and colored. The examination takes up to 30 minutes, allowing the doctor to check the work of the body and obtain information about pathologies.

Isotope scanning is also performed for 30-40 minutes, but requires complete immobility from the patient. A flat image is displayed on paper, not on the screen. These are colored shaded lines.

Both methods of research are performed on an empty stomach. Another special preparation is not needed.

CT and MRI

There are two more modern, but more expensive methods of examining the liver - computer and magnetic resonance imaging. CT is performed using X-rays. As a result of the procedure, up to twelve images (horizontal slices) are obtained, which allows to determine the localization and size of lesions. In addition, the doctor is able to assess the nature of the problem and understand how it affected the surrounding tissues. CT is prescribed for suspected mechanical jaundice, cyst, liver injuries, bleeding, hematomas, cirrhosis and tumors.

MRI is deservedly considered the most accurate method for examining the liver and other organs. Magnetic resonance imaging as accurately as possible reveals neoplasms of even a very small size. During the procedure, you can not only diagnose the tumor, but also establish its nature, detect metastases, assess the patency of the vessels, detect diffuse changes, establish the degree of cirrhosis and much more. The survey is carried out in a special apparatus of tunnel type. The procedure takes 30 minutes or more.

Diagnosis can be carried out with or without contrast. The method is absolutely safe for patients, but requires the control of metal objects. It is necessary to remove everything: jewelry, hearing aids, and removable dentures. Conducting MRI in the presence of shrapnel wounds, metal staples or pins and a pacemaker is possible only after further consultation with a doctor.

Biopsy

Biopsy provides an opportunity to determine the etiology of the disease, its stage and the level of organ damage. The analysis takes a piece of living tissue, which is sent to a histological (tissue), cytological (cellular) or bacteriological study.

There are several types of liver biopsy :

• Puncture;
• Aspiration with ultrasound;
• Transvenous;
• Laparoscopic.

To the planned liver biopsy preparation begin in 7 days. The patient must refuse to take non-steroidal anti-inflammatory drugs and warn about taking anticoagulants. Over 5 days from the diet exclude products that increase gas formation. For 3 days, the reception of Espumizan begins. The procedure is performed on an empty stomach.

The main thing that the patient should understand is that when pain and unpleasant symptoms occur, it is impossible to delay treatment to a doctor. It is necessary to conduct a liver examination. Where to start, the treating doctor should decide, since he will need a complete picture of the condition of the organ. Remember, most problems can be cured with timely access for help.