My Doctor Ordered an Ultrasound...What Does That Mean?

An ultrasound on my liver was ordered. What is next?

If you or your doctor suspect a NASH diagnosis, it's possible you just had some blood work completed, showing your liver enzymes to be out of normal range. Sometimes the next step is undergo imaging to take a look at your liver. Depending on your doctor, and the direction they choose to go with your care, they may order one of the following tests which will take a look at the liver and see what is going on.

The three types of imaging that might take place are: Ultrasound, CT scan, or an MRI.  In this article I am going to cover what is usually the most common first imaging your physician, hepatologist, or gastrologist might order, and that is ultrasound.

What's an ultrasound?

An ultrasound or sonogram is imaging that takes pictures of your liver by bouncing high frequency sound waves off the liver and other organs (ultrasounds are not just used for the liver – let me make that clear, they can be used for helping make many other diagnoses). These sound waves are silent therefore you will not hear or feel anything during this procedure. Ultrasounds can show fatty deposits around the liver.¹

Oftentimes you'll need to fast before your liver ultrasound. Fasting is needed for this exam as food and liquids in your stomach can actually distort what images are seen on the exam. A clear picture is needed to fully determine the condition of your liver.¹

Ultrasound tips

What I have found in my own journey with liver disease, is that I learned all I could about the terminology and wording used for my imaging and diagnosis. That way when I saw my liver specialist, I understood the liver terminology he was sharing with me. This helped me be at ease and feeling “in charge” of my liver health. (My day career today is actually scheduling for an imaging facility!)

Here are 2 radiology terms that may be helpful to know

Lesions - It is an area of the liver or surrounding tissue where damage has been made. It can range from an ulcer type to a more sever type such as a tumor. Oftentimes, if your imaging comes back with this label, more testing might be needed to determine if your lesion is just a fatty deposit or actually cancerous. This testing is called a biopsy.²

Ascites – This is where a large amount of fluid is collected in the abdomen area. Those who have this may appear severely bloated or even pregnant looking with a fully hard belly. There are various ways to treat ascites, and I will address this in a future article as well.³

What to expect during your ultrasound

In an ultrasound exam you may be expected to put on a gown top which will open in the front. From my personal experience they only have me tuck my shirt up above the liver area. The radiologist will then ask you to lay on your back for the imaging. A warm clear jellylike substance will be applied on your upper abdomen area and then a wand like tool will be guided over this jelly to get good imaging for a diagnosis.

An ultrasound is noninvasive and usually only takes anywhere between 30-45 minutes, depending again on what your doctor has ordered. Once you go through it once it becomes old hat so to speak. I personally go for an ultrasound now still every 6 months. That has been recommended from my personal liver team to stay on top of my liver health, and to watch for any signs of possible HCC (liver cancer). In my next article, I will discuss what is a CT scan and what that imaging shows your liver doctor.

I am personally trained in the ultrasounds and what they do and show for my job I work at every day and also, had numerous ones personally ran every 6 months. I do suggest reaching out to your doctor if you have questions about your personal care and ultrasounds, as I am no medical doctor and can only share my personal experience.