When prefer MRI or CT over abdominal ultrasound?

When US is inconclusive, there is suspicion of a focal liver lesion needing characterization (hepatobiliary MRI), pancreatitis with complication (contrast-enhanced CT), or unstable trauma (whole-body CT). For patients with a poor acoustic window, go straight to cross-section.

Does the patient need to fast?

Yes, 6–8 h fasting for adequate gallbladder and biliary tree evaluation. Routine hydration for bladder filling in pelvic studies.

How to measure liver and spleen correctly?

For the liver, measure right lobe (RL) at the mid-clavicular line and left lobe (LL) at the midline, longitudinal plane. Splenic index = length × thickness × width — normal up to 60 cm³ in adults.

Report template — Ultrasound of abdomen total FAST

When to use

Abdominal ultrasound is first-line for abdominal pain, suspected cholelithiasis/cholecystitis, hepatic steatosis, biliary duct dilatation and mass screening. It is operator-dependent and limited by bowel gas and body habitus — when inconclusive, consider CT or MRI.

What to evaluate

Liver: size, contour, echotexture/echogenicity, focal lesions.
Intra and extra-hepatic bile ducts; common duct caliber.
Gallbladder: wall, content, stones, sonographic Murphy sign.
Pancreas (bowel-gas limited): size, main duct, lesions.
Spleen: size, splenic index (up to 60), lesions.
Kidneys, bladder and abdominal aorta when in protocol.
Free intra-abdominal fluid.

Interactive template

Fill the blanks0/1

(EXTENDED FOCUSSED ABDOMINAL SONOGRAPHY FOR TRAUMA – E-FAST) Exame realizado em caráter de emergência para a pesquisa de líquido livre na cavidade abominopélvica, nos hemitóraces e no saco pericárdico. Saco pericárdico: sem líquido detectável pela janela subxifóide. Espaço hepatorrenal (Morrison): ausência de líquido livre. Base do hemitórax direito: ausência de derrame pleural. Espaço esplenorrenal: ausência de líquido livre. Base do hemitórax esquerdo: ausência de derrame pleural. Pelve: ausência de líquido livre. Resultado da avaliação E-FAST: EXAME NEGATIVO POSITIVO. Demais achados eventuais: Referências: Focused Assessment with Sonography for Trauma (FAST). Emergency Ultrasound. 2004. ACEP Policy Statement: Emergency Ultrasound Guidelines. American College of Emergency Physicians. 2001.

Template in Brazilian Portuguese (clinical reporting language). Adapt to your service protocol. Not medical advice — the physician reviews, edits and signs.

How to use

Replace each [...] with the exam's measurement or descriptor.
Adapt the conclusion to your service protocol before signing.
Use the template as a starting point — not a replacement for physician review.
In Laudos.AI, dictate findings in natural speech and the AI structures text in this format for review.

Related classifications

LI-RADS — liver lesion characterization

Frequently asked

When prefer MRI or CT over abdominal ultrasound?: When US is inconclusive, there is suspicion of a focal liver lesion needing characterization (hepatobiliary MRI), pancreatitis with complication (contrast-enhanced CT), or unstable trauma (whole-body CT). For patients with a poor acoustic window, go straight to cross-section.
Does the patient need to fast?: Yes, 6–8 h fasting for adequate gallbladder and biliary tree evaluation. Routine hydration for bladder filling in pelvic studies.
How to measure liver and spleen correctly?: For the liver, measure right lobe (RL) at the mid-clavicular line and left lobe (LL) at the midline, longitudinal plane. Splenic index = length × thickness × width — normal up to 60 cm³ in adults.

References

American College of Radiology — ACR Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum.
Colégio Brasileiro de Radiologia (CBR) — Diretrizes de qualidade em ultrassonografia abdominal.