Approach to improving sonographic visualization of elongated left lobe of the liver and its implications.
OBJECTIVE
To determine whether visualization of the elongated left lobe of the liver can be improved by distending the stomach with water and the implications of this technique.


METHODS
Forty-three out of 87 patients with elongated left lobe of the liver found at abdominal CT were included in this study after obtaining informed consent. Their livers were examined using ultrasound before and after drinking water. The left lobe of the liver was scanned from the subxiphoid and left subcostal approaches, with the sound beam directed to the spleen and the left lobe of the liver neighboring or behind the stomach; the elongated left lobe of the liver overlying the spleen was detected by scanning from the 9th-11th intercostal approach of the left flank.


RESULTS
The overall visualization of the elongated left lobe of the liver before and after filling the stomach with water was 4.7 % (2/43) and 100.0 % (43/43), respectively (P < 0.001); and the overall visualization of the spleen before and after filling the stomach with water was 4.7 % (2/43) and 100.0 % (43/43), respectively (P < 0.001).


CONCLUSIONS
Distending the stomach with sufficient water can substantially improve visualization of elongated left lobe of the liver at ultrasound, potentially improving detection of tumors in the liver and preventing misdiagnosis.
Department of Medical Imaging, The Affiliated Hospital of Hainan Medical College, No. 31 Longhua Road, 570102, Haikou, China. wsz074@yahoo.com.cn.
Size
S
Wu
Department of Medical Imaging, The Affiliated Hospital of Hainan Medical College, No. 31 Longhua Road, 570102, Haikou, China.
Rong
R
Tu
Department of Ultrasound, The Affiliated Hospital of Hainan Medical College, No. 31 Longhua Road, 570102, Haikou, China.
Enhai
E
Zheng
Department of Ultrasound, The Affiliated Hospital of Hainan Medical College, No. 31 Longhua Road, 570102, Haikou, China.
Guangqing
G
Liu
Anatomy; Liver; Ultrasound