How much does ultrasound rule out liver disease?

41M. I’ve had recurrently high liver enzymes (fluctuating between high-normal and close to double the upper bound of normal, with the AST being consistently 10 points below the ALT).

I went for an ultrasound and it came back normal. I know that means normal size, normal blood flow, and no fatty liver, but does it rule out inflammation, cirrhosis, or the development of scar tissue?