General Ultrasound Liver Measurements
Liver measurement and normal value
Normal Value
Hepatic — Measurable Structures
Distance measurement
- Span (MCL)
- LL AP diameter
- CL AP diameter
- Glosus capsul thicnes
- Portal vein dia.
- Hepatic vein dia.
- CBD dia.
- Lesion: L × W × T
Volume measurement
- Liver Volume
- Lesion Volume
Area measurement
- Lesion Area trase
Vascular Structures
- HV Doppler
- PV Doppler
Distance measurement →
Span (MCL): Liver span at the Mid-Clavicular Line (MCL) is the craniocaudal length of the right hepatic lobe measured in centimeters along the right mid-clavicular line on ultrasound, from the superior hepatic margin to the inferior liver margin.
Liver span measures approximately 13.5 cm along the right mid-clavicular line (MCL), within normal limits.
Normal Ultrasound Liver Reference Values by Age
Normal Ultrasound Mid-Clavicular Length of Liver by Age
LL AP diameter:The left lobe anteroposterior (AP) diameter is the maximum thickness of the left hepatic lobe measured in centimeters on ultrasound, typically obtained in the sagittal plane from the anterior to posterior margin of the left lobe.
Normal Ultrasound Left Lobe (LL) AP Diameter by Age
CL AP Diameter: The caudate lobe anteroposterior (AP) diameter is the maximum thickness of the caudate lobe measured in centimeters on ultrasound, typically obtained in the sagittal or transverse plane from the anterior to posterior margin of the caudate lobe.
Normal Ultrasound Mid-Clavicular (CL) AP Diameter of Right Lobe by Age
Glisson's Capsule Thickness: The thickness of Glisson's capsule is the measured thickness of the fibrous connective tissue capsule surrounding the liver, assessed in millimeters on ultrasound.
Normal Ultrasound Glisson's Capsule Thickness by Age
Portal Vein Diameter: The portal vein diameter is the maximum internal diameter of the main portal vein measured in millimeters on ultrasound, typically assessed near the porta hepatis.
Normal Ultrasound Portal Vein Diameter by Age
Hepatic Vein Diameter: The hepatic vein diameter is the internal diameter of the hepatic vein measured in millimeters on ultrasound, usually assessed near its entry into the inferior vena cava.
Normal Ultrasound Hepatic Vein Diameter by Age
CBD Diameter: The common bile duct (CBD) diameter is the maximum internal diameter of the common bile duct measured in millimeters on ultrasound, typically assessed at the porta hepatis.
Normal Ultrasound Common Bile Duct (CBD) Diameter by Age
Lesion: L × W × T: Lesion dimensions represent the maximum length (L), width (W), and thickness (T) of a focal hepatic lesion measured in centimeters on ultrasound, recorded in three orthogonal dimensions.
Span (MCL): Liver span at the Mid-Clavicular Line (MCL) is the craniocaudal length of the right hepatic lobe measured in centimeters along the right mid-clavicular line on ultrasound, from the superior hepatic margin to the inferior liver margin.
| Newborns and Infants (0-2 years): | 40-100mm |
| Children (3-8 years): | 65-120mm |
| (9-12 years): | 75-130mm |
| Adolescents (13-18 years): | 85-140mm |
| Adults (18+ years): | 95-145mm |
LL AP diameter:The left lobe anteroposterior (AP) diameter is the maximum thickness of the left hepatic lobe measured in centimeters on ultrasound, typically obtained in the sagittal plane from the anterior to posterior margin of the left lobe.
Normal Ultrasound Left Lobe (LL) AP Diameter by Age
| Newborns and Infants (0-2 years): | 15-35mm |
| Children (3-8 years): | 25-50mm |
| (9-12 years): | 35-55mm |
| Adolescents (13-18 years): | 45-65mm |
| Adults (18+ years): | 50-70mm |
CL AP Diameter: The caudate lobe anteroposterior (AP) diameter is the maximum thickness of the caudate lobe measured in centimeters on ultrasound, typically obtained in the sagittal or transverse plane from the anterior to posterior margin of the caudate lobe.
Normal Ultrasound Mid-Clavicular (CL) AP Diameter of Right Lobe by Age
| Newborns and Infants (0-2 years): | 30-60mm |
| Children (3-8 years): | 50-80mm |
| (9-12 years): | 65-95mm |
| Adolescents (13-18 years): | 80-110mm |
| Adults (18+ years): | 90-120mm |
Glisson's Capsule Thickness: The thickness of Glisson's capsule is the measured thickness of the fibrous connective tissue capsule surrounding the liver, assessed in millimeters on ultrasound.
Normal Ultrasound Glisson's Capsule Thickness by Age
| Newborns and Infants (0-2 years): | 0.03-0.05mm (30-50 µm) |
| Children (3-8 years): | 0.04-0.06mm (40-60 µm) |
| (9-12 years): | 0.05-0.07mm (50-70 µm) |
| Adolescents (13-18 years): | 0.06-0.08mm (60-80 µm) |
| Adults (18+ years): | 0.07-0.10mm (70-100 µm) |
Portal Vein Diameter: The portal vein diameter is the maximum internal diameter of the main portal vein measured in millimeters on ultrasound, typically assessed near the porta hepatis.
Normal Ultrasound Portal Vein Diameter by Age
| Newborns and Infants (0-2 years): | 3-6mm |
| Children (3-8 years): | 5-8mm |
| (9-12 years): | 7-10mm |
| Adolescents (13-18 years): | 8-12mm |
| Adults (18+ years): | 9-13mm |
Hepatic Vein Diameter: The hepatic vein diameter is the internal diameter of the hepatic vein measured in millimeters on ultrasound, usually assessed near its entry into the inferior vena cava.
Normal Ultrasound Hepatic Vein Diameter by Age
| Newborns and Infants (0-2 years): | 2-4mm |
| Children (3-8 years): | 3-5mm |
| (9-12 years): | 4-6mm |
| Adolescents (13-18 years): | 5-7mm |
| Adults (18+ years): | 5-8mm |
CBD Diameter: The common bile duct (CBD) diameter is the maximum internal diameter of the common bile duct measured in millimeters on ultrasound, typically assessed at the porta hepatis.
Normal Ultrasound Common Bile Duct (CBD) Diameter by Age
| Newborns (<1 month): | <1mm |
| Infants (1 month - 1 year): | <2mm |
| Children (1-10 years): | <3mm |
| Older Children & Adolescents (10-18 years): | <4mm |
| Adults (<60 years): | <6mm |
| Elderly Adults (≥60 years): | <8mm (up to ~10mm) |
Volume measurement →
Liver Volume
Normal Ultrasound Liver Volume by Age
Lesion Volume
Normal Ultrasound Liver Volume by Age
| Newborns and Infants (0-2 years): | 100-300 mL |
| Children (3-8 years): | 400-700 mL |
| (9-12 years): | 600-1000 mL |
| Adolescents (13-18 years): | 800-1400 mL |
| Adults (18+ years): | 1060-2223 mL |
Lesion Area Trase →
:
Vascular structure →
HV Doppler
Normal Hepatic Vein (HV) Doppler Waveform by Age
Hepatic Vein Doppler — Normal Adult Values
PV Doppler
Normal Portal Vein (PV) Doppler by Age
HV Doppler
Normal Hepatic Vein (HV) Doppler Waveform by Age
| Newborns and Infants (0-2 years): | Monophasic or biphasic common (normal variant); S wave 10-20 cm/s |
| Children (3-8 years): | Triphasic in most; S wave 15-25 cm/s; S ≥ D |
| (9-12 years): | Triphasic; S wave 20-30 cm/s; S ≥ D |
| Adolescents (13-18 years): | Triphasic (~80%); S wave 20-30 cm/s; S ≥ D |
| Adults (18+ years): | Triphasic (~80%); S wave 25-35 cm/s; S ≥ D; peak velocity >10 cm/s |
Hepatic Vein Doppler — Normal Adult Values
| Parameter | Normal value (adult) | Notes |
|---|---|---|
| Peak S-wave velocity | 20–50 cm/s | Systolic forward flow; dominant forward wave |
| Peak D-wave velocity | 10–30 cm/s | Diastolic forward flow; usually smaller than S |
| Peak A-wave (reversal) velocity | ≤ 10–15 cm/s | Small brief reversal is normal; prominent reversal is abnormal |
| V-wave (end-systolic reversal) | ≤ 5–10 cm/s (often absent) | May be seen normally as a small notch |
| S/D ratio | > 1 (typically 1.5–2.5) | S wave larger than D wave; reversal (S < D) suggests elevated RA pressure |
| A-wave reversal duration | < 20–30 ms | Brief reversal is normal; prolonged reversal indicates elevated RA pressure |
Normal Portal Vein (PV) Doppler by Age
| Newborns and Infants (0-2 years): | Hepatopetal; PSV 15-30 cm/s (lower cut-off: 10 cm/s preterm, 15 cm/s term) |
| Children (3-8 years): | Hepatopetal; PSV 14-41 cm/s (median ~26 cm/s) |
| (9-12 years): | Hepatopetal; PSV 14-41 cm/s (median ~26 cm/s) |
| Adolescents (13-18 years): | Hepatopetal; PSV 15-40 cm/s (median ~26 cm/s) |
| Adults (18+ years): | Hepatopetal; PSV 20-40 cm/s (mean ~19-21 cm/s) |
Portal Vein Doppler — Normal Adult Values
| Parameter | Normal value (adult) | Notes |
|---|---|---|
| Peak systolic velocity (S) | 15–40 cm/s | Hepatopetal flow (toward liver); mild respiratory variation |
| Peak diastolic velocity (D) | 10–30 cm/s | Usually slightly lower than systolic; flow remains hepatopetal |
| Mean flow velocity | 15–25 cm/s | Time-averaged mean velocity; used to calculate flow volume |
| Pulsatility index (PI) | 0.5–1.2 | Reflects phasicity; low PI suggests loss of pulsatility |
| Flow volume | 600–1200 mL/min | Varies with body size and cardiac output |
| Flow direction | Hepatopetal (toward liver) | Reversal (hepatofugal) indicates portal hypertension or steal phenomenon |
| Phasicity | Mild phasic (follows respiration) | Loss of phasicity suggests liver disease or venous congestion |
| Variance (S/D) | 1.0–2.0 | Increased variance suggests elevated hepatic venous pressure |
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