Diffuse liver disease refers to any condition that affects the liver parenchyma throughout the organ rather than creating a focal mass or lesion. The most common forms include hepatic steatosis or fatty liver, hepatitis, fibrosis, and cirrhosis. On ultrasound, diffuse liver disease typically manifests as changes in the liver’s overall echogenicity and texture. A fatty liver appears brighter than the adjacent kidney cortex with increased attenuation of the sound beam, while cirrhosis may show a shrunken, nodular liver with surface irregularity and signs of portal hypertension. Ultrasound is usually the first imaging study performed to evaluate diffuse liver disease and has become increasingly capable of grading severity through techniques like shear wave elastography.
Sonography Term