Liver [Hepatic] ultrasound is a non-invasive, lower cost, and repeatable technique for determining focal and parenchymal disease of the liver.
Ultrasound can potentially identify various factors that are useful in evaluating chronic liver disease: nodularity of the liver surface (which reflects the presence of regenerative nodules and fibrous septa often seen in cirrhosis), coarseness of the parenchyma, size of lymph nodes around the hepatic artery, patency and flow of veins and arteries, spleen size (which if enlarged can suggest portal hypertension), hepatocellular carcinoma, and small volume ascites.
The use of high-frequency ultrasound transducers is reported to be more reliable than low-frequency ultrasound in diagnosing cirrhosis. In those with HCV, assessment of biochemical markers (prothrombin time, albumin, total bilirubin, and platelet count) is the initial step used by most clinicians in determining the presence or absence of cirrhosis. If biochemical markers are conflicting or suggestive of cirrhosis then abdominal imaging would be used to confirm overt cirrhosis and/or portal hypertension, and screen for hepatocellular carcinoma [liver cancer].