Ultrasound in the assessment of hepatomegaly: A simple technique to determine an enlarged liver using reliable and valid measurements

Abstract

Introduction Knowledge of the size of the liver is an important factor in diagnosing liver disease. Hepatomegaly is a term used to describe a liver that is enlarged beyond its normal dimensions, and ultrasound is often a front line investigation in the suspicion of hepatomegaly. This study sought to develop a reference range for the size of the normal liver using a simple, reliable and valid measurement technique. Methods Two ultrasound images of the liver and a blood test were taken from 126 participants. Three simple linear measurements were taken from these two images and converted to a liver volume using a published equation. Results The reference range for liver volume in adults without liver pathology was found to be 1060–2223 cm3. Conclusion This new measurement technique and reference range is simple and easy to perform in the clinical environment. It has the potential to discriminate a liver normal in size to one with hepatomegaly.

The inter‐rater and intra‐rater reliability of a recently developed equation to determine liver volume using three simple two‐dimensional ultrasound measurements

“…Recently, Childs et al . developed an equation to measure the volume of the liver using three simple ultrasound measurements.…”

“…developed an equation to measure the volume of the liver using three simple ultrasound measurements. This method was shown to be a more reliable indicator of liver size than the common measurement techniques currently being used in clinical practice . The three linear measurement technique consists of a dome to tip (DT) measurement in the midclavicular line (MCL) (A), an anterior to posterior (AP) measurement in the MCL (B) and an AP measurement in the midline (C).…”

“…Further to this, a reference range was developed, which reported values lying within 1060 and 2223 cm 3 when calculated using this equation were found to represent a liver within normal range. It should be noted that this is an estimation of liver volume only and not as accurate as the determination of liver volume using CT or MRI …”

“…A normal liver should measure between 1060 and 2223 cm 3 when using the measurements A, B and C placed into the equation [0.84 × A ×B × C] + 343.71 . This method has been shown to be more accurate as an indicator of liver size than what sonographers are currently commonly using as a determination of an enlarged liver, being a liver measuring over 16 cm in the MCL . Protocol for the plane of this measurement differs from department to department, and this technique is based on studies that showed little rigour…”

“…6,7 Ultrasound provides an inexpensive, readily accessible and simple way to visualise the liver. 8 Recently, Childs et al 9 developed an equation to measure the volume of the liver using three simple ultrasound measurements. This method was shown to be a more reliable indicator of liver size than the common measurement techniques currently being used in clinical practice.…”