Vogel H M, Scherer K, Look D
Endoscopy. 1980 Jul;12(4):166-74. doi: 10.1055/s-2007-1021736.
In a prospective study 54 patients with normal liver, chronic alcoholic and non-alcoholic hepatitis and cirrhosis--all diagnoses established by laparoscopy and histology--were examined by gray-scale scanning. The following criteria proved helpful in differentiating between normal and pathologic states: variations in liver size and form, attenuation and echo pattern (form, density and distribution of echoes). The ultrasonic diagnosis is relatively simple in alcoholic fatty liver and cirrhosis, and becomes more difficult or even uncertain in mild chronic hepatitis without fibrosis. Confirmation of suspected liver disease by direct morphological methods such as laparoscopy and histology is therefore necessary.