Female 54 years old Reason: assess for steatosis, any e/o cirrhosis History: high output cardiac failure with unknown etiology, h/o hepatic steatosis in the past LIVER: Markedly coarse and echogenic liver consistent with fatty infiltration. No focal masses. Liver capsule appears smooth. Main portal vein is patent with peak velocity of 30.8 cm/s.BILIARY TRACT: Patient status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation. Common bile duct measures 5.4 mm.PANCREAS: Pancreas is not well-visualized.SPLEEN: Spleen is normal echogenicity measuring 13.8 cm.KIDNEYS: Normal cortical medullary differentiation. No hydronephrosis, shadowing calculi, or mass. Left kidney measures 11.7 cm. Right kidney measures 11.8 cm.OTHER: No significant abnormalities noted.
Marked hepatic steatosis without sonographic evidence of cirrhosis. No focal mass is identified, however with this degree of hepatic steatosis, ultrasound ability to detect small masses is diminished. If there is high clinical suspicion for hepatic mass, CT is recommended.