Diffuse changes in the liver, parenchyma: signs, causes, treatment. What are moderate diffuse changes in the liver

If the condition of the liver is normal, its structure is homogeneous, its outlines are clear, the surface is smooth, and the edges are even. At the same time, the vessels of the organ are not enlarged, and the structure of the hepatic ducts does not change. If diffuse changes in the liver occur, its structure is disrupted cellular level. The point is that the parenchyma of the organ, its main tissue, increases. Its main component is hepatocytes.

WHAT DO DIFFUSE CHANGES LOOK LIKE IN THE LIVER

Changes in the parenchyma are detected on ultrasound. During the study, it is revealed that the liver tissue looks lumpy, its surface becomes not smooth, and its outlines are not clear. All these are echo signs of diffuse deformations of the parenchyma. In its normal state, weak echogenicity of the tissues is noted.

Diffuse changes in the liver are not the presence of localized foci of altered parenchyma, but deformation of the liver tissue as a whole. If compaction occurs in only one area, it may be focal-diffuse changes.

Such manifestations may indicate minor pathologies, but we can also talk about serious illnesses. If diffuse changes in the liver are detected, this is not a definitive diagnosis. This phenomenon is a symptom, and upon its detection, further examination is necessary to determine what kind of disease has affected the liver tissue.

If the disease is detected in time, the liver tissue can be restored quite quickly and returned to them normal structure and rid the organ of disease. This cannot be said about advanced cases of the disease, since late stages processes of parenchyma change are often irreversible.

Diseases that cause diffuse changes in the parenchyma

Reasons diffuse changes These are diseases that impair the functioning of the organ.

Disorders can be either primary or secondary – resulting from diseases of other organs (for example, diabetes mellitus).

The most common causes of the problem are alcohol abuse and obesity.

The organ can also suffer from frequent diets, and especially strict ones. The most dangerous thing is sharp "switching" from a normal diet to a diet with strict restrictions.

Unfortunately, many of them can occur without any symptoms, so they are detected only during examination.

But sometimes they make themselves felt with the following signs:

  • Yellowing of the sclera and skin around eyes;
  • Dimly expressed painful sensations in the area of ​​the right forearm or right hypochondrium;
  • A feeling of heaviness in the area of ​​the right hypochondrium or forearm.

If such signs are observed, you should consult a doctor as soon as possible and conduct an examination in order to identify the disease in time.

Changes in the liver parenchyma come in the following forms:

  • Hepatic fibrous;
  • Hepatic-dystrophic;
  • Hepatic-sclerotic;
  • Hepatic-hypertrophic;
  • Diffuse changes in the liver associated with the accumulation of fluid in the parenchyma.

Types of liver changes

Due to the close relationship of the liver with other organs, diffuse changes can be as follows:


This phenomenon can also occur in children. The reason for this may be congenital pathologies liver. If during pregnancy future mom I was sick with hepatitis, the baby has such problems. Because of this and the risk of developing other pathologies, termination of pregnancy is usually recommended if a woman is diagnosed with hepatitis during pregnancy.

Changes in a child’s organ may also develop due to antibiotic treatment. Use of toxic drugs children's body is going through a very difficult time.

How to treat diffuse liver changes?

Considering that we are talking about a symptom, and not about a specific diagnosis, we can talk about its elimination only if the provoking disease is eliminated.

Treatment for any of these diseases requires that it be developed by a doctor.

Whatever the disease, it is very important to follow a diet when eliminating it. It has a positive effect on the condition of the liver and is important step, accelerating recovery.

Here are the basic nutritional rules that you need to follow to speed up treatment:

  • It is necessary to avoid eating smoked, fried, and fatty foods. The list of non-recommended foods also includes heavy, rich broths and decoctions;
  • Spicy, sour, salty dishes should also be excluded;
  • It is also necessary to give up alcoholic beverages;
  • In order for the liver tissue to recover faster, extreme caution should be exercised when taking medications. Treatment should be carried out only with those prescribed by the doctor;
  • You should stop smoking or at least significantly reduce the number of cigarettes you smoke;
  • Baking, White bread, sweets are products that should also be prohibited;
  • You should also avoid products containing a large number of coarse fiber (for example, cabbage), as well as those that enhance fermentation processes (in particular, legumes).

If diffuse changes in the liver are mild, sometimes doctors limit themselves to prescribing hepatoprotectors - drugs that help maintain the liver.

The following drugs have a similar effect:

  • "Karsil";
  • "Gepabene";
  • "Essentiale";
  • "Livenziale";
  • "Hepalex".

Prevention

To avoid the risk of diffuse hepatic changes, follow these rules:

Changesparenchyma is a reason to start treatment, but not a reason to panic, so consult a doctor in a timely manner.

Liver - unique organ, which performs many functions in the body. It cleanses the blood, produces and inactivates hormones, participates in the digestive process, replenishes energy reserves, and neutralizes foreign aggressive substances and toxic compounds.

Moreover, this organ is created in such a way that its cells do not have nerve endings and with various disorders affecting the liver tissue, it does not hurt. Therefore, most liver diseases occur without pronounced symptoms and are detected only in advanced stages.

Human long years may not suspect that he is sick until the volume of the liver increases. Then the capsule covering the organ stretches, touching the nerve processes of nearby tissues. There is pain in the hypochondrium on the right, the skin turns yellow, and digestive processes. Often, early liver pathologies are detected during examination of other organs. And if the patient is informed about diffuse changes in the liver, he begins to worry. What does this mean, and how to proceed?

Hepatic diffuse transformations include uniform changes in the structure of the liver. This is not a disease, but only a manifestation of the underlying pathology. Changes can be sclerotic, edematous, dystrophic, fibrous in nature. But to make an accurate diagnosis, the patient will need to be examined.

This condition can occur at any age, as a result of minor violations liver activity, and because of its severe lesions. Diffusion is the relatively uniform interconnection of atoms and molecules. At negative impact Due to damaging factors, these connecting links are disrupted, which affects the balance of the interaction of substances. In the liver, the vascular lumens change, the lobes of the parenchyma are rearranged, and its edges and boundaries change.

Experts identify the following causes of the disorder:

In children, diffuse changes develop with jaundice associated with liver dysfunction, and with diseases of the gallbladder. Negative Impact environment, malnutrition, bad habits, bad heredity - all this can become an impetus for development pathological process.

At the beginning, the restructuring of the liver structure occurs without pronounced symptoms. Sometimes a person may experience nausea and mild pain in the right side. Further, the victims experience:

  • constant pain, heaviness in the hypochondrium on the right;
  • yellowness of the skin and mucous membranes;
  • loss of appetite;
  • bloating, diarrhea, nausea, vomiting;
  • weight loss;
  • bitter taste, dry mouth, thirst;
  • nervousness;
  • headache;
  • chronic fatigue.

Types of pathologies

Diffuse changes due to bacterial or viral damage change the intrahepatic ducts, causing other organs to suffer. They are classified by localization. Lesions may occur:

Diagnostic measures

The main and most informative method Determination of pathology is examination using ultrasound. Such a study of the parenchyma makes it possible to accurately determine the size of the organ, the degree of deviation from the norm, and identify enlarged The lymph nodes, tuberosity, swelling, granularity, helminthic lesions, hemorrhages, neoplasms.

Examination of the hepatic ducts helps determine the size of the lumen, find stones present in the biliary tract, identify blockage of blood vessels, and assess the volume of lymph nodes. When diagnosing the gallbladder, the doctor assesses the condition of the duct and identifies the presence of tumors and stones.

Increased echogenicity indicates the course of pathological processes associated with cholelithiasis and the proliferation of tumor growths. Reduced echogenicity indicates exacerbation of hepatitis and inflammation of the gallbladder.

The patient needs to prepare for the procedure. The day before, avoid eating foods that increase gas formation, take an antispasmodic and do an enema. Based on the results obtained, the specialist will be able to make a diagnosis or refer the patient for additional examination to determine the further course of treatment.

Additional liver tests include:

  • computed tomography and magnetic resonance imaging are non-invasive diagnostic methods that make it possible to see the pathology in the image, assess the severity and location in 3D format;
  • radiography;
  • biochemical blood test that determines the level of hemoglobin, glucose, lipids, proteins, cholesterol, urea, etc.

Various liver diseases correspond to certain signs that are visible on ultrasound.

  • with steatosis, the organ enlarges, its shape changes, and a distinct pattern of the organ’s veins is visible;
  • with cirrhosis, the growth of connective tissue increases, the surface of the organ is lumpy, uneven, and the echogenicity is high;
  • with abscesses, neoplasms, hemorrhages, specific echo signs are detected;
  • with hepatitis, the echo signal increases, the size of the liver increases, and in some places heterogeneity is detected in the tissues.

Therapy methods

Since hepatic diffuse mutations are not a separate diagnosis, but only indicate hidden pathological processes, treatment is based on eliminating the real reason violations.

Traditional methods

Depending on the etiology and nature of the changes, the following traditional treatment regimens are prescribed:


ethnoscience

It is known that the liver is a unique organ that can recover. In addition to medications, you can help her folk remedies. There are many recipes that cleanse and restore the liver. As a result, it decreases in size, its structure becomes homogeneous, and pain in the hypochondrium disappears.

Patients should note that cleaning can only be carried out with the permission of a doctor.

You can use it to treat the liver:

  • ginger;
  • lingonberry leaves;
  • Birch buds;
  • mint;
  • dog-rose fruit.

These phytoingredients help both together and individually. You can use the following recipes to prepare the product:


Prevention nutritional therapy

To prevent diffuse liver degeneration and biliary tract, necessary:

  • Healthy food;
  • do not overwork;
  • use medications as prescribed by your doctor;
  • do not refuse annual preventive examinations;
  • treat chronic diseases;
  • give up bad habits.

Any liver disease requires strict adherence to a diet and a categorical refusal of certain foods. The main food for the patient is boiled, steamed, stewed dishes. All drinks and foods consumed for liver diseases should not be too cold. The diet includes inclusion in the diet sufficient quantity proteins, carbohydrates, vitamins, minerals and limits fats. Excluded:

  • fatty varieties meat and fish;
  • fried dough;
  • bakery;
  • offal;
  • rich broths;
  • mushrooms;
  • spicy seasonings;
  • canned food;
  • fatty fermented milk products;
  • semi-finished products;
  • sausages;
  • nuts;
  • legumes;
  • sparkling sweet water.

Meals should be 5-6 times a day, in small portions. You need to have dinner no later than 2 hours before bedtime. The diet includes:

  • crackers;
  • hard biscuits;
  • non-sour berries and fruits;
  • fresh vegetables;
  • greenery;
  • lean meat and fish;
  • rosehip decoction;
  • weak tea;
  • low-fat cheeses and dairy products;
  • omelet, boiled eggs;
  • vegetable soups;
  • juices, fruit drinks, compotes;
  • cereals.

Complications and prognosis

If a patient has diffuse hepatic changes, then the prognosis directly depends on the underlying disease, which caused, although hidden, unpleasant symptoms. Sometimes it's enough to exclude negative factors to return the liver normal sizes and get rid of pathological phenomena.

For steatosis caused by alcohol intoxication, the complete exclusion of provoking factors returns the cells to a healthy state within six months.

It happens that a person is forced to take medications for decades that have a toxic effects to hepatocytes. In such cases, the development of diffuse transformations in the liver is inevitable. To prevent complications, doctors prescribe hepatoprotectors (it is better to take them in courses in spring and autumn). These drugs create a protective shell on the surface of the parenchyma that does not allow toxins to pass through.

No less favorable forecasts doctors give viral diseases. Patients need to undergo a course of antiviral therapy. The main thing is to apply for it in a timely manner medical assistance until the deformation of the tissue has gone too far. With cirrhosis and tumor, the normal structure of the liver cannot be restored. But the sooner the patient starts treatment, the greater the chance of stopping pathological changes.

To understand why diffuse modifications are dangerous, it is worth considering patient reviews:

Ivan: “When there was pressure in my right side, nausea after almost every meal, my head began to feel dizzy and my skin turned yellow, I went to the doctor. I am not a fan of hospitals and drugs. I was often sick as a child, so I always wait until the last minute to avoid getting there.

I was admitted to the hospital. An ultrasound revealed diffuse transformations of the organ and found stones in the bile duct. I'm waiting for surgery to remove stones. Probably, if I had rushed earlier, I could have gotten by with pills.”

Victoria: “When, based on the results of the ultrasound, I was diagnosed with “diffuse changes,” I asked my doctor how scary it was. She said it was just a symptom, like a red throat and snot, but it didn't necessarily indicate the flu.

Since special clinical manifestations I didn’t have one, I was recommended Karsil twice a year and diet No. 5. I feel great, thanks healthy eating I even lost a couple of kilos. I’ll go for another ultrasound soon, I think everything will be fine.”

Structure and functions of the liver

The liver is the largest gland in the human body, which consists entirely of parenchymal tissue (liver parenchyma consists of cells - hepatocytes) and does not contain a cavity. The liver is located in the abdominal region, in the right hypochondrium. The basis of the liver parenchyma is lobules, between which are located blood vessels And bile ducts. The bile ducts carry bile produced by the liver to gallbladder, and from there, through the common bile duct, it enters the duodenum, having previously united with the pancreatic ducts (thus, liver diseases certainly affect general condition pancreas).

In the human body, the liver performs a very large number of different functions. First of all, it is responsible for neutralizing and removing toxic products that enter the body. In addition, proteins are synthesized in the liver and reserves of glucose are deposited, converted into glycogen. Finally, the liver produces bile, which is necessary for the digestion of fats.

Today, liver diseases are far from uncommon. This is due to the fact that modern lifestyle, nutrition and frequent use alcohol significantly damages the liver tissue, which is why diffuse changes in the liver parenchyma develop. Not last place occupies and viral lesions, which are often left unattended and thanks to this are transmitted from person to person. There are a very large number of different methods aimed at diagnosing various pathological conditions liver. At various diseases Ultrasound examination of the liver is most often used. Unfortunately, it is impossible to make a final diagnosis based only on ultrasound data; for this it is necessary to carry out a number of laboratory and instrumental studies.

The ultrasound method is based on the principles of echolocation, that is, the reflection of sound by tissues and visualization of the reflected sound on the monitor screen. The appearance of each type of fabric is different due to the different coefficient of sound reflection, making it easy for a specialist to determine the size, position and functional state of the studied organs, including diffuse changes in the liver parenchyma. Unfortunately, in most cases it is not possible to differentiate changes detected by ultrasound, which requires a number of other studies aimed at detailing and recognizing the identified changes.

Diffuse changes in the liver parenchyma

Normal liver tissue is a homogeneous, weakly echogenic structure, among which bile ducts and blood vessels with increased echogenicity are visible. Diffuse changes in the liver parenchyma indicate that the liver tissue is completely changed. Such changes are typical for minor functional changes, and for very severe lesions (parenchyma). Therefore, it is so necessary to carry out additional research. First of all, it is necessary to carry out a complete laboratory test, which will allow you to find out how severely the liver is affected. In addition to examining the liver itself, the conditions of the bile ducts are studied, duodenum and, if necessary, all the digestive organs.

Changes in the liver parenchyma appear as a result of diseases such as viral hepatitis, alcoholic hepatitis, fatty degeneration liver, various metabolic liver diseases. With fatty degeneration of the liver, its size increases and the echogenicity of the structures increases. If the liver is slightly enlarged and there is slight increase echogenicity, this may indicate chronic hepatitis(this disease can occur in a number of ways various reasons, ranging from alcoholism to viral infections). To find out the true cause of the disease, a series of additional methods research.

Diffusion is a process of interaction between molecules and atoms of substances, the purpose of which is to achieve a certain concentration in a given area. If the balance is disturbed, the functional functioning of the internal organs is disrupted.

Diffuse changes in the liver are not a separate disease, but its consequence, manifested in the form of a significant increase in the parenchyma of the organ in question.

What are diffuse liver changes

As mentioned above, diffuse changes in the liver are not a pathology, but one of its manifestations. There is no such disease in ICD-10, but there are a number of other diseases associated specifically with the liver and that can have a direct effect on the parenchyma.

Negative external influences lead to disruption of the connection between individual molecules. At the same time, changes also occur in the functioning of hepatocytes, which leads to the growth of connective and fatty layers.

Perfectly healthy cells suddenly begin to die, the structural integrity of the liver tissue is disrupted, its size increases, and it becomes heterogeneous. Ultrasound examination can tell about the presence of diffuse changes in the liver with 100% accuracy. If the liver is healthy, then the device shows only its weakly echogenic structure.

Heterogeneity of parenchyma composition should not cause panic. If you are interested in what diffuse changes in the liver are, you should carefully study them possible varieties. Thus, a change in the structure of the liver is a signal about the development of one of the forms of hepatitis or obesity.

The only thing that a diagnosis formulation such as “diffuse enlargement, compaction or deformation of the parenchyma” means is that the patient will have to undergo additional examination to exclude the development of tumors and damage to other organs. a heterogeneous structure of the liver also occurs with cirrhosis.

Diffusely heterogeneous and focal changes manifest themselves in the form of increased echogenicity and decreased echodensity on ultrasound.

Diffuse enlargement of the liver can be dangerous only if its changes functional features(on different stages This is exactly what happens in cirrhosis and hepatitis). The change is considered destructive, with lesions reaching a size of 0.5-2 centimeters. Patients with such significant enlargement of the affected areas require constant monitoring.

Types of disease

In the process of studying pathological changes in the structure of the liver, following types violations:

  • Minor diffuse changes in the liver parenchyma. A disease of a common type, the degree of danger of which is determined based on special research. One of its features is disruption of the functioning of not only the liver, but also the pancreas, which is associated with the development of hepatitis, alcohol or drug use.
  • Moderate diffuse changes in the liver. They occur due to poisoning, any external influences, as well as damage to the body by viruses. Disappears after taking vitamins and eliminating the source of irritation. So, if the cause of the formation of fine-grained and granular changes in the liver parenchyma was the use of alcohol, then giving it up will help rapid recovery organ tissues.
  • Severe diffuse changes in the liver. Most often they are a consequence of untreated hepatitis, cirrhosis, tumor or cyst. With diffuse changes in the liver according to the type under consideration, well-defined swelling of the parenchyma is observed.
  • Diffuse reactive changes. The main functions of the liver are impaired, which manifests itself in the form of exacerbation of pancreatitis and negative reactions from the pancreas.

When determining the density of structural tissues, diffuse focal changes are often detected, alternating with rebuilt tissue. Such changes occur during the development of hepatitis with metastases.

Causes

Among the causes of diffuse changes in tissue, a special place is given to the presence in the patient of:

  • congestive cholecystitis,
  • bad habits,
  • concomitant diseases requiring long-term treatment with the help of antibiotics,
  • viral diseases,
  • liver cirrhosis,
  • signs of dystrophy against the background of a sharp weight loss,
  • lipomatosis.

The causes of diffuse changes are also hidden in poor heredity. To eliminate this possibility or slow down the process of tissue destruction, it is necessary to eat properly (fatty, salty and spicy foods accelerate the rate of development of the disease), monitor sugar levels and weight.

In children, the causes of diffuse changes are congenital pathologies or the presence of similar changes in the mother. So, if hepatitis was detected during pregnancy, it is recommended to terminate it artificially. The chances of having a healthy, viable child are minimal.

Symptoms

Signs of diffuse changes in the liver do not appear immediately or are completely absent. The body begins to signal the presence of pathology exclusively at the stage liver failure.

The patient experiences:

  • feeling of heaviness and nausea after eating,
  • unpleasant metallic taste in the mouth, worse in the morning,
  • severe itching (a causeless rash appears on the skin),
  • dizziness and headache,
  • weakness, malaise,
  • irritation,
  • pain in the right side or in the abdomen and back.

Urine is darker and feces become light. The skin and even the area around the tongue becomes unnatural yellow. In a number of patients, the liver enlarges so much that it becomes noticeable without palpation.

The heterogeneous structure of the liver is the reason for conducting a serious comprehensive study of the whole organism.

The final diagnosis is established after:

  • donating blood for general analysis,
  • biochemistry,
  • carrying out coprogram and OAM,
  • x-ray examination,
  • undergoing an ultrasound,
  • performing an organ biopsy,
  • passing markers for the presence or absence of cancer cells,
  • how the tomography was performed.

Most often, the disturbed echostructure of tissues is detected by ultrasound, but if dystrophic changes not expressed enough, necessary various tests blood and urine. Thus, with the help of biochemical and general urine analysis, it is possible to determine the level of hemoglobin, cholesterol and bilirubin.

Diagnostics allows us to determine whether the norm of leukocytes, albumin, glucose, acids, fibrinogen and urea is disturbed. If the level of at least one of the control indicators is elevated, the patient is sent for additional examinations.

To exclude pathologies of the gallbladder and other organs that are not clearly expressed and therefore not noted on ultrasound, a computer and MRI examination of the liver is performed. It helps to identify the degree of its increase and all kinds of inhomogeneities. The diffuse changes that occur are considered in three-dimensional space. In this case, incipient liver dystrophy is revealed, and its medium-grained structure is determined.

Ultrasonography

Diffuse changes in the structure of the liver are observed on ultrasound in areas with high, low or very high echogenicity. Such echographic signs indicate the development of hepatitis, fatty liver disease, liver amyloidosis, infection of the body with helminths and cancerous tumors.

Echo signs make it possible to identify the disease even if the patient does not complain of anything. Ultrasound shows any pathological changes; it is used to determine the degree of change in the size of the walls of blood vessels and bile ducts.

If diffuse changes in the liver of a reactive type have occurred, the device will show that the liver is enlarged and heterogeneous. In this case, an increase in echogenicity is observed, and the coarse-grained structure of the liver changes. The heterogeneous echostructure in cirrhosis is associated with the formation of nodes.

In addition, with this disease, thickening of the walls is observed portal vein and collaterals. A healthy liver should not be enlarged. At the same time a sharp decline granularity and a decrease in the size of the organ indicate that the disease is in its final stage.

When examining moderate hematomegaly against the background of the formation of simple cysts, small air bubbles are found in the lumen of the bile ducts, externally resembling hyperechoic inclusions. Secondary and subsequent studies show that the bubbles change their original position.

Unfortunately, using ultrasound alone to diagnose accurate diagnosis It’s not always possible. So, in the case of hepatitis, the echo signal only indicates that the organ is enlarged, its structure has changed, but the indicators differ with the same units of measurement. The cause of such changes is determined by the results of laboratory tests.

Changes in the liver parenchyma in a child

Reactive changes in the liver parenchyma in a child signal pathological processes during internal organs. Signs of the disease are well expressed, changes biochemical parameters blood moderate. If the child is one year old or less, then there is a chance that timely treatment will allow the integrity of the organ to be completely restored.

Reactive changes in the liver small child indicate the development of:

  • peptic ulcer,
  • pancreatitis,
  • intestinal pathologies,
  • systemic pathologies,
  • problems with the endocrine system,
  • poisoning,
  • thermal injuries,
  • oncological diseases.

Liver problems may occur in children after taking certain medicines, including those that the mother took during pregnancy.

This is very dangerous; due to the fact that the first signs of the disease do not appear immediately or are completely absent, treatment may be significantly delayed. To prevent this from happening, children at risk are regularly examined by a doctor.

Treatment

Not knowing how to cure diffuse liver diseases traditional methods many patients practice treatment with folk remedies and follow a strict diet. In general, this treatment of liver diseases allows you to get rid of discomfort And external signs diseases in relatively short time, but in some cases it is not enough.

So, if the cause of diffuse changes is associated with infection of the body with worms, then the patient is prescribed anthelmintics. For viral or bacterial infection Antibiotics and antiviral drugs are prescribed.

Recovery normal operation liver patients take vitamins and mineral complexes, substances that prevent fat deposition, steroid drugs that help normalize hormonal levels.

What does “Diffuse liver changes” mean? This is an ultrasound diagnosis made by sonologists after a detailed examination of the patient. This diagnosis is not specific disease, the latter needs to be installed. This is what clinicians do.

Classification of diseases

Diffuse changes in the liver are observed in the following pathological processes:

How to properly prepare for an ultrasound examination to identify signs of diffuse changes in the liver? As a rule, to identify a pathological process in the liver using ultrasound special training No need. However, given that the pancreas and gallbladder are being examined at the same time, the following rules must be adhered to:

  • The study is carried out on an empty stomach to identify echo signs of diffuse changes in the liver and pancreas
  • If the patient is overweight, then two to three days before the test you should exclude milk, brown bread, legumes, cabbage and everything that stimulates increased gas formation in the intestines
  • Taking antifoam agents on the eve of the study (this can be espumizan and Activated carbon), since gases in the intestines will not reveal diffuse changes in the structure of the liver
  • A cleansing enema immediately before the study is not indicated.

Ultrasound variants of liver echogenicity

Signs of diffuse changes in the liver parenchyma are detected by the doctor in comparison with the normal echogenicity of the liver. Therefore, in sonology it is customary to distinguish four degrees of liver echogenicity.

Normal is considered to be the one in which the liver parenchyma is comparable in echogenicity to right kidney When elevated, there is a moderate increase in the echogenicity of the right kidney. In the case of high echogenicity, this difference is very large. The liver can also be superechoic, where it resembles the reflection of sound from bone.

Diffuse changes in the liver during hepatosis and other pathological processes are characterized by changes in echogenicity. As a rule, most often it decreases. Increased echogenicity is usually observed with focal compactions, for example, liver cysts.

Ultrasound manifestations of fatty degeneration

Fatty liver disease is a buildup in liver cells. increased amount lipids. Ultimately, this leads to dysfunction of hepatocytes with the development of liver failure varying degrees expressiveness. This condition can be observed in patients with obesity, diabetes mellitus, lipid metabolism disorders, etc.

Diffuse changes in the liver that can be detected using ultrasound include the following:

  • Liver size is increased
  • The surface of the liver is convex
  • Deformation when pressed by an ultrasonic sensor is not detected
  • The pattern obtained by ultrasound is rough and dense
  • Ultrasound transmission through the liver is reduced
  • The veins of the liver are clearly defined
  • No pathology from the portal vein is detected.

Diffuse fatty liver changes in this pathology can be either large-droplet or small-droplet. Each of these options has its own specific ultrasound picture, similar to morphological manifestations.

Thus, diffuse changes in the liver parenchyma are important ultrasound criteria for fatty hepatosis. The diagnosis is confirmed and biochemical research blood.

Ultrasound manifestations of liver cirrhosis

Sonographic signs of diffuse changes are variable. First of all, it depends on the stage of the disease and the time that has passed since its development. pathological growth connective tissue in the liver. The main manifestations of liver cirrhosis, which are visible when ultrasound examination, are:

  • Hepatomegaly and diffuse changes in the liver are observed on early stages disease, then the size returns to “normal”, and even later it decreases significantly (the liver shrinks)
  • The echogenicity of the liver increases
  • Nervousness of the surface of the liver

It should be noted that there is no direct connection between pronounced diffuse changes in the liver and the severity of liver failure. It happens that the ultrasound picture is quite bright, and the liver is functioning well. This is explained by the fact that liver function depends on the number of dead hepatocytes and on the violation of liver architecture, as well as on the number of regenerated nodes (places of proliferation of connective tissue).

The neglect of the pathological process in cirrhosis is also indicated by the presence and degree portal hypertension– a condition in which the pressure in the portal vein increases. In this case, ultrasound signs of diffuse changes in the liver are combined with symptoms such as:

  • The diameter of the portal vein is more than 1.5 cm
  • The diameter of the splenic vein is more than 1 cm
  • The diameter of the splenic vein changes during the respiratory phases.

Ultrasound pathology of the liver in a child

Diffuse changes in the liver in a child can be associated with various pathological processes, including those mentioned above. There may also be hereditary or congenital diseases, namely:

  • Heart defects that lead to heart failure
  • Various intrauterine infections
  • Metastatic tumors
  • Primary liver tumors
  • Metabolic disorders
  • Exposure to hepatotoxic substances
  • Atresia (fusion) of the biliary tract.

Diagnostic search for diffuse liver changes

If ultrasound reveals diffuse changes in the liver, then further diagnostic search is required. Its goal is to establish a definitive diagnosis. Therefore, the following studies are recommended:

  • CT scan
  • Scintigraphy
  • X-ray examination
  • Biochemical blood test
  • Blood test for viral hepatitis, etc.

After this, they are formed clinical groups. The most important of them is a combination of hepatomegaly and diffuse changes in the liver. This may be a sign:

  • swelling of the liver parenchyma due to inflammation
  • plethora due to heart failure
  • steatosis with diffuse liver changes
  • hereditary accumulation diseases, etc.

Treatment

Treatment of diffuse liver changes depends on the cause that led to them. Therefore, it can be carried out both conservatively and operational methods. Indications for surgery are:

  • Portal hypertension
  • Liver cysts
  • Liver tumors
  • Metastases and others.

In other cases, as a rule, it is carried out drug therapy. As one of the most common reasons for moderate diffuse changes in the liver, the use of hepatoprotectors is indicated, antiviral agents(at viral hepatitis), choleretic drugs etc. During the treatment process, it is necessary to carry out ultrasound and biochemical control. This allows you to evaluate the effectiveness of the treatment.

Diet for diffuse changes in the liver also plays a big role in restoring it normal structure and functioning. The following products are recommended for such patients:

  • Crackers
  • Bread is not hot
  • Soups without frying
  • Lean meat
  • Lean fish
  • Cereals
  • Vegetables excluding spinach, garlic, onions, radishes and radishes
  • Low-fat varieties of cottage cheese
  • Hard-boiled eggs
  • Tea, coffee, compotes.

You should avoid foods such as:

  • Rich broths
  • Lard and fatty meats
  • Fish with increased content fat
  • Mushrooms
  • Legumes
  • Smoked meats
  • Conservation, etc.

In conclusion, it should be noted that diffuse changes in the liver and pancreas can be detected using ultrasound. This is a preliminary diagnosis that requires clarification using other examination methods. Based on this, the nature of the pathological process is determined, after which appropriate treatment is carried out.

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