In chronic hepatitis, how does the liver typically appear on ultrasound?

In chronic hepatitis, the liver typically appears hyperechoic and small on ultrasound due to several pathological changes that occur as the disease progresses. As chronic liver inflammation and damage continue over time, the liver can undergo fibrosis, which results in scarring and ultimately leads to a decrease in liver size. This reduction is often accompanied by changes in echotexture, where the liver becomes more echogenic compared to normal liver tissue due to the increased fibrous connective tissue relative to healthy hepatocytes.

This hyperechoic appearance is a key ultrasound finding in cases of chronic liver diseases, including hepatitis, as it represents the liver's response to ongoing injury and repair processes. The small size of the liver, commonly referred to as shrunken or atrophied, further indicates that there has been significant structural change over time.

In summary, the identification of a small, hyperechoic liver on ultrasound serves as an important diagnostic indicator of chronic hepatitis and its complications.