Can ascites due to liver disease be detected by ultrasound (B-ultrasound)?

In general, hepatic ascites refers to fluid accumulation in the abdominal cavity caused by liver disease. Whether hepatic ascites can be detected by B-mode ultrasound depends on the patient's specific condition. If discomfort occurs, timely medical consultation is recommended. Detailed analysis is as follows:

If there is a large amount of ascites and the patient has no significant interfering factors such as abdominal bloating or obesity, B-ultrasound can usually clearly detect it. In such cases, ultrasound can directly show irregular anechoic areas in the abdominal cavity, roughly estimate the volume of accumulated fluid, and simultaneously observe the liver’s shape, size, and presence of underlying conditions like cirrhosis, thus providing clear diagnostic evidence.

However, if the amount of ascitic fluid is very small or the patient suffers from severe abdominal distension or obesity, B-ultrasound may have difficulty detecting it accurately. Small amounts of fluid are easily obscured by intestinal gas or fatty tissues, making anechoic areas less apparent on ultrasound images, which could lead to missed diagnosis. In such cases, clinical symptoms and other tests should be used for further evaluation.

Prior to the examination, patients should fast or hold urine as instructed by the doctor to reduce interference from intestinal gas or urine on imaging results. If no ascites is found on initial ultrasound but symptoms such as abdominal distension or lower limb edema are present, repeat ultrasound after an interval or consider alternative diagnostic methods. After the examination, promptly provide the results to the physician for comprehensive assessment based on the overall clinical picture. Once diagnosed, regular follow-up ultrasounds should be performed as directed by the physician to monitor changes in fluid volume and evaluate treatment effectiveness.