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Click the image to enlarge for a printable version Image at the level of the superior liver segments. Use your right fist to represent the liver segmental anatomy.

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Normally measures about 15 cm at mid clavicular line in adults, there is much variation in pediatric populations by age and size It is not visible on a frontal view The liver is covered by a layer of connective tissue referred to as glisson’s capsule

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The liver is normally more echogenic then the renal cortex.

The goal of this article is to give an overview of intraoperative liver ultrasound, including the indications, different ultrasound techniques, and the ultrasound appearance of normal anatomy, more common anatomic variations, and common hepatic tumors. Anatomic structures that are expected to be visualized during routine liver ultrasound include the right/left lobes of the liver, caudate lobe, intrahepatic blood vessels (portal, hepatic veins), gallbladder, and extrahepatic bile ducts. It was first described by the french surgeon claude couinaud in 1957 Measurement of liver size in the largest craniocaudal diameter in the mcl during inspiration in a supine subject

Measured in the midhepatic line with a large field of view from the post diaphragm to the lower anterior edge. Liver in midclavicular line hepatic venous anatomy in right subcostal view main portal vein bifurcation in right subcostal view liver in epigastric sagittal view There are eight liver segments Segment iv is sometimes divided into segment iva and ivb according to bismuth

The numbering of the segments is in a clockwise manner

Segment i (the caudate lobe) is located posteriorly