Scanning Planes

Scanning Planes in Liver Ultrasound

In liver ultrasound imaging, different scanning planes are used to comprehensively evaluate the liver's anatomy, vasculature, and any pathological changes. Here’s a concise overview of the scanning planes in liver ultrasound:
1. Transverse (Axial) Plane

• Orientation: The transducer is placed horizontally across the upper abdomen.
• View:Cross-sectional view of the liver.
• Structures Visualized:
• Right and left lobes of the liver.
• Portal vein in its transverse section ("Mickey Mouse sign").
• Gallbladder (if included).
• Inferior vena cava (IVC).

2. Sagittal (Longitudinal) Plane

• Orientation:The transducer is oriented vertically along the midline or right upper quadrant.
• View: Longitudinal view of the liver.
• Structures Visualized:
• Liver span (craniocaudal length).
• Relationship to the kidney (e.g., "liver-kidney interface").
• IVC in longitudinal section.

3. Subcostal Plane

• Orientation:Transducer is angled upward under the costal margin.
• Use:Often used in deep inspiration to improve liver visualization by moving the liver below the rib cage.
• Structures Visualized:
• Anterior liver segments.
• Hepatic veins and diaphragm.

4. Intercostal Plane

• Orientation:Transducer is placed between the ribs in the right upper quadrant.
• Use:Helps avoid rib shadows.
• Structures Visualized:
• Superior liver segments.
• Diaphragmatic surface.
• Right hepatic lobe.

5. Coronal Plane

• Orientation: Transducer placed in the mid or anterior axillary line, scanning vertically.
• View: Vertical slice from side to side.
• Structures Visualized:
• Lateral and medial segments.
• Hepatic veins draining into the IVC.

6. Oblique Planes

• Orientation:Angled transducer positioning tailored to follow vascular pathways or segmental anatomy.
• Use:For targeted views of:
• Portal vein bifurcation.
• Hepatic veins.
• Lesions.

Key Tips for Liver Ultrasound Scanning

• Patient Position:Supine, left lateral decubitus, or upright to optimize visualization.
• Breathing Technique: Deep inspiration enhances liver window by displacing the liver downward.
• Acoustic Window:Use the right kidney or full bladder (if scanning caudally) as acoustic windows.