How effective is the ultrasound at seeing small amounts of fibrosis or cirrhosis in the liver? do radiologists get a good enough view of the liver, gallbladder, and bile ducts with this test to detect very early damage in these areas?

See answer: Ultrasound is the imaging study of choice for gall bladder and bile ducts, as well as for the liver. Biopsy is the gold standard for fibrosis/cirrhosis.High resolution US is 90% sensitive and specific for the diagnosis of Cirrhosis. But it would not show early fibrosis. The Liver Fibrosis Panel (HepaScore) is a single blood test that estimates the likelihood and severity of cirrhosis.

Early cirrhosis: Early changes probably would only show with a liver viopsy. U/S is a poor choice to show any changes. Your best bet is MRI of the abdomine to pick any changes in the structures you named.