50-year-old male with liver failure. History of amyloid and multiple myeloma. LIVER: Liver are normal in size. The liver parenchyma is diffusely and heterogeneously echogenic. Given this appearance, I cannot exclude underlying mass and CT or MR would be indicated. Liver has a cirrhotic morphology. Limited color and spectral Doppler demonstrates patency with flow reversal in the main portal vein which appears somewhat attenuated. GALLBLADDER, BILIARY TRACT: Cholecystectomy. Biliary tract is normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted.OTHER: Mild ascites.
Heterogeneous hepatic parenchyma. Cannot exclude underlying mass.Reverse flow in portal venous system consistent with portal hypertension.