If you began to notice soreness in the right side, a bit of bitterness appeared in your mouth, often for no reason it starts to vomit, then it is likely that these are problems with the liver. But do not start to read on the coffee grounds and take advertised drugs. It is better to consult a specialist and conduct a liver examination. Only after studying the results of the tests, performing an ultrasound scan, CT scan, MRI scan, radioisotope scan or biopsy, you can prescribe the correct treatment.
General blood analysis
Usually the first step in examining the liver is testing. First of all, doctors always prescribe a general blood test. This is the simplest study, which will not indicate a specific problem, but will make it possible to determine the presence of inflammation of the organ. And if a decrease in the level of platelets is detected, then we can assume viral hepatitis, since the work of liver cells is disrupted.
Biochemistry
You will have to donate blood from a vein by which liver enzymes (aspartate aminotransferase and alanine amino transferase) will be detected. This analysis allows us to judge damaged cell membranes that pass specific cellular enzymes from the liver to the blood. The norm of these enzymes is less than 41 U / L ALT. If it is exceeded, then this may be a sign of hepatitis of various forms. This analysis is called blood biochemistry. It allows you to determine the ratio of ALT, AST, identify alkaline phosphatase and determine the level of bilirubin, to assess the concentration of gamma-glutamyltransferase (GGTP). The analysis determines more than 40 indicators.
Ultrasound scan
An important stage of a liver examination is an ultrasound scan. Ultrasound diagnosis allows you to determine the size of the liver and gall bladder. The method shows such diffuse changes as hepatosis, all types of pancreatitis, cirrhosis. So, for example, with hepatosis in the body, inclusions of fat cells will be noticeable. Hepatocytes and fat have different densities, which means that the ultrasound image will look variegated. And as the disease progresses, liver cells will begin to be replaced by connective tissue, and an ultrasound scan will show signs of fibrosis.
As for focal changes, examination of the liver with ultrasound will clearly show areas with increased density, which may be hemangioma, adenoma, cancer metastases, calcifications. The method also clearly allows you to determine the reduced echogenicity of the sites, which may indicate the presence of sarcoma, lymphoma, abscess or hematoma.
Having studied the data, the doctor will not be able to make an accurate diagnosis, but he determines the direction for further examination of the liver, excluding rejected options.
For the patient, such a study is completely painless. But a little preparation is required, eliminating flatulence.
Computer scintigraphy and isotope scanning
Modern methods of examining the liver include a radioisotope scan or more relevant computer scintigraphy of the organ system, including the liver, gall bladder, and ducts. The first method has been actively used in medical practice since the beginning of the 60s and somewhat lost its relevance. The second method appeared relatively recently and has already gained popularity among diagnosticians. The study allows you to assess the degree of functioning of the body, determine its size, identify tumors and establish the presence of chronic processes.
Scintigraphy is carried out using colloidal sulfur (or other organic matter), which is labeled with radioactive technetium 99. The radioactive isotope is administered to the patient intravenously or inhaled. Then, using a gamma camera, radiation is captured, converted and transmitted to a computer. The image is layered and color. The examination takes up to 30 minutes, allowing the doctor to monitor the work of the body and obtain information about pathologies.
Isotope scanning is also carried out 30-40 minutes, but requires complete immobility from the patient. A flat image is displayed on paper, not on the screen. These are colored shaded lines.
Both research methods are performed on an empty stomach. No other special training is needed.
CT and MRI
There are two more modern, but more expensive methods for examining the liver - computed tomography and magnetic resonance imaging. CT is performed using x-rays. As a result of the procedure, up to twelve images (horizontal sections) are obtained, which makes it possible to determine the location and size of the lesions. In addition, the doctor gets the opportunity to assess the nature of the problem and understand how it affected the surrounding tissues. CT is prescribed for suspected obstructive jaundice, cysts, liver injuries, bleeding, hematomas, cirrhosis and tumors.
MRI is deservedly considered the most accurate method for examining the liver and other organs. Magnetic resonance imaging accurately detects neoplasms even of a very small size. At the same time, during the procedure, you can not only diagnose the tumor, but also establish its nature, detect metastases, evaluate vascular patency, detect diffuse changes, establish the degree of cirrhosis, and much more. The examination is carried out in a special apparatus of the tunnel type. The procedure takes 30 minutes or more.
Diagnosis can be done with or without contrast. The method is absolutely safe for patients, but requires control of metal objects. It is necessary to remove everything: jewelry, and hearing aids, and removable dentures. MRI in the presence of shrapnel wounds, metal staples or pins and a pacemaker is possible only after additional consultation with a doctor.
Biopsy
A biopsy provides an opportunity to determine the etiology of the disease, its stage and level of organ damage. A piece of living tissue is taken for analysis, which is sent for histological (tissue), cytological (cell) or bacteriological examination.
There are several types of liver biopsy :
- puncture;
- suction with ultrasound control;
- transvenous;
- laparoscopic.
Preparation for a planned liver biopsy begins in 7 days. The patient is obliged to refuse to take non-steroidal anti-inflammatory drugs and to warn about taking anticoagulants. For 5 days from the diet exclude products that increase gas formation. For 3 days, they start taking Espumisan. The procedure is performed on an empty stomach.
The main thing that the patient should understand is that when pain and unpleasant symptoms occur, it is impossible to delay a visit to a doctor. It is necessary to conduct a liver examination. Where to start, the attending physician must decide, because he will need a complete picture of the state of the organ. Remember, most problems can be cured with timely help.