What can gray-scale changes in liver parenchyma help detect?

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Gray-scale ultrasound assesses how liver tissue reflects sound and what its texture looks like. When fat accumulates in the liver (fatty infiltration), the parenchyma becomes more echogenic, so the liver appears brighter than normal. Focal lesions, such as tumors, also alter the parenchymal texture on gray-scale, making nodules or masses stand out as areas with different echogenicity. Thus gray-scale changes are most helpful for detecting fatty infiltration and liver tumors. Gallstones show up as bright echoes with shadowing in the gallbladder, not as changes in the liver parenchyma. Portal hypertension and vascular occlusion are better evaluated with Doppler flow patterns and other signs rather than gray-scale texture alone.