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The liver has the consistency of a soft, solid, malleable, organ with a “jello” – like consistency. It is highly vascular giving it a reddish brown color. Due to its size and vascular nature the liver seemed to be at the center of life itself, and it thus attained godly powers over this culture. By virtue of its malleable and vascular character it is easily lacerated with a tendency to hemorrhagic complications.
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Character of the liver
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(Image courtesy of Ashley Davidoff M.D.)
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It has a soft tissue density by CT, (25-40HU – non contrast), is more echogenic than the parenchyma of the kidney by ultrasound, and is marginally brighter than the spleen on T1 weighted images, and darker than the spleen on T2 weighted images.
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Character of the liver
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The malleability of the organ results in easy structural deformity by neighbouring structures. In this case the tendinous insertions of the diaphragm impinge on the soft liver and cause ridges on its surface. Even the hyperinflated lung anterolaterally is able to indent the liver. (Image courtesy of Ashley Davidoff M.D.)
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The following is a cross sectional, portal venous phase CT. In this study, the spleen is more dense than the liver. On a non-contrast CT the liver is slightly denser than the spleen due to the glycogen content of the liver, and the water nature of the spleen.
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Character of the liver
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This cross sectional image shows the liver and spleen in the portal venous phase. The spleen is slightly denser than the liver. (Image courtesy of Ashley Davidoff M.D.)
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Character of the liver
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(Image courtesy of Philips Medical System, Ultasound)
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Character of the liver
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This T1 weighted MRI of the liver shows the spleen to be darker than the liver, reflecting the higher water content of the spleen. (Image courtesy of Ashley Davidoff M.D.)
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Character of the liver
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This T2 weighted MRI of the liver shows the spleen to be much brighter than the liver reflecting the higher water content of the spleen. (Image courtesy of Ashley Davidoff M.D.)
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Applied Anatomy Character
The liver is commonly injured with blunt trauma producing a classic “bear claw” abnormality.
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Character of the liver
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The normal homogeneous pattern of the liver has been replaced by lacerations that run along the axis of the blood vessels. (Image courtesy of Ashley Davidoff M.D.)
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To try and visualize this abnormality, sometimes it is easy to visualize a large bear claw.
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Bear claw injury
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The normal homogeneous pattern of the liver has been replaced by lacerations that run along the axis of the blood vessels. (Image courtesy of Ashley Davidoff M.D.)
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In the following image, a mass can be identified in the posterior aspect of the right lobe of the liver. Notice the difference in character between the mass and the rest of the liver.
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Hemangioma
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The puddling of the contrast in the periphery in the early phases of imaging is characteristic of a benign hemangioma. These are rather soft lesions that conform to the more rigid shape of the liver capsule. (Image courtesy of Ashley Davidoff M.D.)
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Additional abnormalities are seen in patients with masses in the liver. In this non-contrast cross sectional CT image the normal homogeneus soft tissue density of the liver is disturbed by a heterogeneous mass with a lower density periphery and central coarse calcification. This mass represents a metastatic carcinoma.
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Hemangioma
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In contrast to the benign hemangioma, this aggressive lesion pushes the capsule and deforms the surface of the liver. This mass represents a calcified metastatic carcinoma. (Image courtesy of Ashley Davidoff M.D.)
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