How is normal liver echotexture described on ultrasound?

• A. Heterogeneous with high-level echoes
• B. Uniformly hypoechoic
• C. Homogeneous with low-level echoes, isoechoic or slightly hyperechoic to renal cortex
• D. Cystic with anechoic compartments

Answer: (C)

Normal liver echotexture on ultrasound is a homogeneous, evenly echogenic parenchyma. It should be isoechoic to, or only slightly brighter than, the renal cortex, with uniform texture throughout. That’s why describing the liver as homogeneous with low-level echoes and isoechoic or mildly hyperechoic to the renal cortex fits best. If the liver appeared heterogeneous, very bright, very dark, or cystic, that would suggest pathology such as steatosis, fibrosis, or focal lesions, rather than a normal scan.