DIPLOMADO EN
ECOGRAFIA INTEGRAL
X DIPLOMADO BARCELONA 2012
HIGADO I
DR. RICHARD M ARIAS GUERRERO
TRANSDUCTOR 3,5 MHz
PROYECCIONES TRANSVERSAL, LONGITUDI-
NAL, OBLICUA.
INSPIRACION SOSTENIDA PARA EVALUAR
CUPULA Y MEDIR.
LMC PARALELO A RCD. INCLINAR TRANSDUC
TOR 35 GRADOS (VISTA SUBCOSTAL)
RASTREO EN LONGITUDINAL
RASTREO INTERCOSTAL
MEDICIONES: HEPATOMETRIA VERTICAL
LOBULOS DERECHO E IZQUIERDO.
HEPATOMETRIA LONGITUDINAL. INDICE C/LD
(O,65)
SISTEMATICA PARA LA
EVALUACION ABOMINAL
AREA HEPATICA: LOB. DER., LOB. IZQ.,
VENAS PORTA Y SUPRAHEPATICAS,
VESICULA BILIAR, COLEDOCO.
AREA PANCREATICA Y GRANDES VASOS
ABDOMINALES.
VEJIGA, INTESTINO Y MSC. PSOAS
RIÑON DER. E IZQ.
BAZO
LOBULOS SEGMENTOS
DERECHO ANTERIOR. POSTERIOR
IZQUIERDO MEDIAL. LATERAL
CAUDADO
CISURAS: CISURA LOBAR PRINCIPAL
CISURA INTERSEGMENTARIA DER.
CISURA INTERSEGMENTARIA IZQ.
CLP
VENAS HEPATICAS:
INTERLOBARES E INTERSEGMENTARIAS
MEDIA: CISURA LOBAR PRINCIPAL
DERECHA: CISURA INTERSEG. DER.
IZQUIERDA: CISURA INTERSEG. IZQ.
VENA PORTA:
INTRASEGMENTARIAS
CADA SEGMENTO TIENE PROPIO APORTE
SANGUINEO (ARTERIAL, PORTAL, VENOSO)
COINCIDENCIA CON RADIOLOGOS
LOCALIZAR LESION CON PRECISION PARA
CIRUJANOS
DIVISION LONGIT.: VENAS HEPATICAS
4 SECCIONES
DIVISION TRANSV.: PEDICULOS PORTALES
PED. PORTAL DER.: OBLICUO INTERCOSTAL
PED. PORTAL IZQ.: OBLICUO SUBXIFOIDEA
Couinaud C: Le foie: Etudes anatomiques et chirurgi-cales. Paris, Masson, 1957
CLV
ANT.
SAILD
SASLD
SPILD
SPSLD
POST.
SEGMENTO 2 O 3?
Sonographic demonstration of Couinaud's liver segments.
D Smith, Downey, A Spouge, and S Soney
JUM June 1998 17:375-81
SEGMENTO 4 A O 4 B?
Sonographic demonstration of Couinaud's liver segments.
D Smith, Downey, A Spouge, and S Soney
JUM June 1998 17:375-81
MEDIAL LATERAL
SMLI SLILI
SLSLI
C
LIGAMENTO HEPATODUODENAL (POR-
TA HEPATIS)
LIGAMENTO FALCIFORME
LIGAMENTO REDONDO
LIGAMENTO CORONARIO
LIGAMENTO TRIANGULAR IZQUIERDO
LIGAMENTO TRIANGULAR DERECHO
SAGITAL
PORTA HEPATIS
VB
VCI
LIG. FALCIFORME
LIG. TRIANGULAR DER.
SANGRE PARCIALMENTE OXIGENADA
APORTA 50% DE OXIGENO REQUERIDO POR
HEPATOCITOS
PARED ECOGENICA (VAINA TEJ. CONECTIVO)
DOS RAMAS: DERECHA E IZQUIERDA
RAMA DERECHA: RAMA ANTERIOR Y POST.
RAMA IZQUIERDA: ASCENDENTE Y
DESCENDENTE
ARTERIAL: ARTERIA HEPATICA
VENOSA: VENAS HEPATICAS
AHC
AE
TC
BORDE REGULAR, BIEN DEFINIDO
BORDE POSTERIOR REGULAR, HIPERECOICO,
CONTINUO (DIAFRAGMA)
PARENQUIMA DE ECOPATRON HOMOGENEO,
ISOECOICO O LEVEMENTE HIPERECOICO
RESPECTO AL PARENQUIMA RENAL.
VENA PORTA DE PAREDES HIPERECOICAS,
PERPENDICULAR A VS. HEPATICAS
VENAS HEPATICAS LONGITUDINALES, SIN
PAREDES VISIBLES
PARENQUIMA
<<<ESTEATOSIS
NORMAL>>>>>
Computerized Medical Imaging and Graphics 28 (2004) 289–293
Liver echogenicity: measurement or visual
grading?
Tapio Vehmasa,*, Ari Kaukiainena, Katariina Luomaa,b, Martina Lohmanc,
Markku Nurminena, Helena Taskinena
As a conclusion, computerized measurements of liver
echogenicity suffer from the lack of an integrated
diagnostic approach, which can be reached only by
medically trained observers. US echogenicity
measurements
should therefore, be dealt with care, even if they are echo
ratios. Experienced observers’ grading is currently the
preferred method for ultrasonic evaluation of liver echo
texture.
HEPATOMETRIA VERTICAL DEL LOBU-
LO DERECHO: HASTA 15 CM.
HEPATOMETRIA VERTICAL DEL LOBU-
LO IZQUIERDO: HASTA 6 CM.
HEPATOMETRIA LONGITUDINAL
VENA PORTA: MENOR DE 13 mm.
VENA ESPLENICA: MENOR DE 9 mm
JUM November 1, 2003 vol. 22 no. 11 1155-1161
Factors Affecting Liver Size A Sonographic Survey of 2080 Subjects
1.Wolfgang Kratzer, MD, Violetta Fritz, MD, Richard A. Mason, MD,
2.Mark M. Haenle, Volker Kaechele, MD and the Roemerstein Study Group
Results. The average measured liver diameter (midclavicular line) ± SD was 14.0 ±
1.7 cm (median, 13.9 cm; range, 9.4–21.3 cm; average in male subjects, 14.5 ± 1.6
cm; and average in female subjects, 13.5 ± 1.7 cm).
Conclusions. The sonographic measurement of liver size at the midclavicular line
was shown to be an easy and practical method for routine use. Only in 239 (11.5%)
of 2080 subjects did the size of the liver measured at the midclavicular line exceed
16 cm. Body mass index and body height are the most important factors
associated with the diameter of the liver measured at the midclavicular line.
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CLP
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