The liver is one of the principal organs of our body involved in over 500 physiological functions related to metabolism, digestion, immunity, and storage of nutrients, which makes it an essential organ to preserve life. Given that there are a number of approaches to measure liver length through diagnostic 2D sonography, this work aims to determine the most accurate measurement of this organ. Cadaveric specimens (n = 21) were employed to assess measurements in midclavicular line (MCL) and midaxillary line (MAL). Each measurement was calculated in anteroposterior (AP) and craniocaudal (CC) planes. In addition, in situ measurements were obtained by accessing the organ through the anterior thoracoabdominal wall. Statistical differences were detected between MCL and MAL measurements (p < 0.05), a positive correlation between MAL CC and in situ anterior measurements were noted (r = 0.97). Liver size, as assessed through in situ measurements, varied as a funtion of BMI and waist circumference (p < 0.05). It is concluded that CC measurement of the RLL in MAL from the uppermost right hemi-diaphragm to the inferior tip of the right lobe through a horizontal line parallel to the anterior liver wall is the most accurate measurement of the organ by sonography.

Introduction. This study aims to establish objective anatomical criteria to obtain accurate and reliable measurements of the right liver lobe (RLL) length by ultrasound while considering sex and anthropometry of the patient. Methods. Thirty-three (n = 33) adult participants underwent two-dimensional (2D) and panoramic (PAN) ultrasound imaging of the RLL in the anterior axillary region (AAR). Each measurement was performed in the standard oblique plane and in a tested craniocaudal (CC) plane by two independent observers. Pearson analysis was conducted to evaluate correlation between measurements and Intraclass Correlation Coefficient (ICC) for inter-rater reliability. Two-tail paired T test was used to compare groups. Statistical significance was attained at p < 0.05. Results. The proposed craniocaudal 2D RLL length was 13.0 ± 1.5 cm for females and 14.1 ± 1.3 cm for males whereas PAN RLL size was 13.7 ± 1.8 cm for females and 15.0 ± 1.1 cm for males. A strong correlation between the proposed 2D CC measurement of the RLL length with PAN CC measurements was found (r = 0.87). Inter-rater reliability for 2D CC measurements showed high reliability (ICC 0.96). Discussion. CC measurement of RLL by ultrasound in AAR is a precise and reliable measurement that may allow for the routine monitoring of RLL length across time.

The craniocaudal (CC) length of the right lobe of the liver (RLL), liver texture, size of the main portal vein, and hemodynamics of the hepatic artery, were sonographically evaluated in female diabetic and non-diabetic patients. A One-way ANOVA, a Tukey's post-hoc test, and a Kruskal-Wallis with post-hoc Dunn's test, were employed. Non-symptomatic differences in liver anatomy were detected among non-controlled type 2 diabetes patients. They exhibited the longest CC length of the RLL (p = 0.04) as well as an enlarged main portal vein (p = 0.04). Hepatic artery resistive index (RI) was higher among controlled type 2 diabetes patients (p = 0.04). These differences were not attributed to fatty infiltration. Non-controlled type 2 diabetes patients exhibited significantly higher alanine aminotransferase, lower high-density lipoprotein cholesterol, and higher triglyceride levels, than in non-type 2 diabetes patients. Longitudinal sonography may provide valuable diagnostic information in the management of type 2 diabetes.

Damage to the liver is a common clinical consequence of chronic diabetes mellitus type 2 (DM2). This study evaluates whether ultrasound shear wave elastography and hemodynamics of the portal vein and the hepatic artery can complement traditional clinical work-up data for the monitoring of liver health among DM2 patients. Methods: Sixty-four (64) participants (31 controls and 33 patients with confirmed type 2 diabetes mellitus) between 21 to 74 years of age were recruited. Liver size, stiffness and hemodynamics of the portal vein and the hepatic artery were evaluated. Glycated hemoglobin (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were monitored. Student’s t-test was employed with significance attained at p <0.05. Results: Asymptomatic significant differences were detected among DMT2 patients: (1) Largest Liver size (p=0.04); (2) Higher liver stiffness (p=0.04); (3) Higher alkaline phosphate levels (p=0.03); (4) Higher HbA1c levels (<0.001) and (7) presence of moderate to severe liver fibrosis. DM2 F1 stage has higher liver stiffness (0.006) and HbA1c levels (<0.001).