Liver Ultrasound Scan

What is a liver ultrasound?

Liver ultrasound—also called a hepatic ultrasound, liver sonogram or USG liver—uses high-frequency sound waves to create live images of your liver in real time. It is painless, emits no radiation, and is the first-line test for assessing liver size and structure, steatosis (fatty change), signs of chronic liver disease or cirrhosis, focal lesions (cysts, hemangioma, masses), and for looking at the gallbladder and bile ducts. Because ultrasound is widely available and quick, it’s often ordered after abnormal liver blood tests (raised ALT/AST/ALP/GGT) or symptoms like right-upper-abdominal pain or jaundice.

Why would a doctor order a liver scan?

Common reasons include:

• Elevated liver enzymes or abnormal LFT profile (ALT/AST/ALP/GGT/bilirubin).
• Unexplained abdominal pain, especially in the right upper quadrant (RUQ), or bloating.
• Jaundice (yellow eyes/skin), pale stools, dark urine—concern for biliary obstruction.
• Monitoring chronic liver disease: fatty liver (NAFLD/MAFLD), hepatitis B/C, autoimmune liver disease, alcohol-related liver disease.
• Findings on other imaging (e.g., incidental liver lesion on CT/MRI) requiring characterisation or follow-up.
• History & risk: metabolic syndrome, type 2 diabetes, high BMI, significant alcohol intake, family history of liver disease or HCC.

Ultrasound may be part of a broader abdominal assessment that also checks the gallbladder (gallstones/sludge), common bile duct (dilatation), pancreas (where visible), right kidney, and portal vein flow (with Doppler).

What we examine & normal anatomy

In a typical private liver ultrasound, the sonographer evaluates:

• Liver size, shape, and echogenicity (brightness). “Homogeneous echotexture” is normal.
• Surface contour: a smooth surface is normal; nodularity raises concern for cirrhosis.
• Intrahepatic ducts and common bile duct (CBD): checked for dilation or obstructive stones.
• Gallbladder: wall thickness, gallstones, polyps, sludge, and sonographic Murphy sign.
• Portal vein & hepatic veins (Doppler when indicated): patency and direction of flow.
• Right kidney and upper abdomen where clinically relevant.

Normal ultrasound descriptors include: “liver is normal in size and echotexture,” “no focal lesions identified,” “gallbladder normal,” and “CBD within normal calibre.”

Normal vs abnormal liver ultrasound

A normal scan shows a smooth, homogeneous liver with appropriate brightness and no discrete masses. The report may say “liver unremarkable,” which simply means no abnormality was seen.

Abnormal scans may demonstrate one or more of the following:

• Increased echogenicity (bright liver): suggests fatty liver or steatohepatitis.
• Coarse/heterogeneous echotexture: may reflect chronic liver disease or evolving fibrosis.
• Nodular contour or atrophic/small liver: raises concern for cirrhosis.
• Ascites (free fluid): often associated with advanced cirrhosis or portal hypertension.
• Focal lesions (cysts, hemangioma, solid nodules): require description and appropriate follow-up.
• Dilated bile ducts or thickened gallbladder wall: can indicate obstruction or inflammation.

Common findings explained

1) Fatty liver (hepatic steatosis)

Ultrasound is sensitive for moderate-to-severe steatosis. The liver appears brighter than the kidney (“hepatorenal brightness”). Reports may say “increased echogenicity,” “diffuse fatty infiltration,” or “echogenic liver.” Fatty liver is common in metabolic syndrome, obesity, insulin resistance, and can also occur with alcohol use or certain medications. Lifestyle change (diet, activity, weight loss) often improves findings over time.

2) Cirrhosis / chronic liver disease

Classic sonographic signs include coarse heterogeneous echotexture, nodular surface, caudate lobe hypertrophy, splenomegaly, and sometimes ascites. Doppler may show altered portal vein flow. Early cirrhosis, however, can be subtle and not always detected by ultrasound—this is where elastography (FibroScan/MRE) helps quantify stiffness (fibrosis).

3) Spots, cysts, hemangioma, and other lesions

• Simple cysts typically appear as anechoic (black), thin-walled, and benign. They are very common and often require no treatment.
• Hemangioma—a common benign vascular lesion—often appears hyperechoic (bright), well-defined, and may be incidentally found.
• Focal fatty sparing or deposition can mimic lesions but reflects patterned fat distribution rather than a mass.
• Solid lesions / suspicious nodules may require contrast CT/MRI and hepatology referral to characterise further.

4) Biliary and gallbladder findings

Because the gallbladder and bile ducts are adjacent, many “liver scans” also evaluate gallstones, biliary dilation, or cholecystitis. Your report may therefore mention gallbladder polyps, sludge, or CBD diameter.

Preparation & fasting requirements

To optimise image quality, most clinics ask you to:

• Fast for 6–8 hours (no food). Water is usually allowed in small sips; take prescribed medication unless told otherwise.
• Avoid alcohol for 24 hours prior if possible (it can transiently alter appearance).
• Wear comfortable clothing that allows easy access to the upper abdomen.

If you are diabetic or pregnant, or have specific medical needs, please follow tailored instructions from your clinic.

What happens during the scan?

1. You’ll lie on an examination couch, usually on your back and then slightly on your left side.
2. Warm gel is applied to your right upper abdomen.
3. The sonographer moves a handheld probe to obtain liver views in different planes; you may be asked to hold your breath briefly to minimise motion.
4. Where indicated, Doppler is used to assess blood flow in the portal/hepatic veins.
5. The full appointment usually takes 15–30 minutes.

The test is painless. You can resume normal activities straight after.

Results, phrasing & what they mean

Your written report will use standard ultrasound terms. Examples include:

• “Liver is normal in size and echotexture. No focal lesions.” – a normal study.
• “Increased echogenicity, compatible with fatty liver.” – steatosis is likely.
• “Coarse heterogeneous echotexture with nodular contour.” – suggests chronic liver disease/cirrhosis.
• “Anechoic thin-walled cyst, benign appearance.” – simple cyst noted.
• “Indeterminate focal lesion – recommend CT/MRI.” – needs characterisation.
• “No focal hepatic lesions identified.” – no masses seen on ultrasound.

Remember: ultrasound detects many liver problems, but not all. If symptoms persist, enzymes remain abnormal, or risk is high, further testing (bloods, elastography, CT/MRI, or hepatology review) may be advised even after a “normal” scan.

Ultrasound vs FibroScan vs MRI/CT

• Ultrasound: best first-line test for structure, fatty change, and obvious complications; portable, quick, and no radiation.
• FibroScan (transient elastography): measures liver stiffness (fibrosis) and controlled attenuation parameter (fat) non-invasively—complements ultrasound when staging disease.
• MRI/CT: used for problem-solving and characterising lesions; MRI with contrast is excellent for liver lesions and iron/fat quantification.

Cost of a private liver ultrasound (London & UK)

Private liver ultrasound typically costs £150–£300 depending on clinic, whether the gallbladder/bile ducts and pancreas are included, and if Doppler is required. Your fee generally includes:

• Appointment with an experienced sonographer or radiologist.
• Scanning of the liver (and upper abdominal organs when part of package).
• Immediate feedback and a formal written report.

Package options are often available (e.g., “upper abdomen” or “full abdominal” ultrasound that includes liver, gallbladder, pancreas, spleen, and kidneys).

Locations & “near me” availability

Appointments are available in central London and selected UK cities, with same-day or next-day slots. If you searched for “liver ultrasound near me” or “private liver scan London”, choose your nearest clinic during booking. Many sites offer early morning, lunchtime, evening, and weekend availability.

Frequently asked questions (FAQs)

Book a Private Liver Ultrasound

Choose a location, select a time, and complete your details—no referral needed in most cases. Same-day and next-day appointments are often available.