53 years old, Male, Reason: transaminitis. please evaluate for evidence of cirrhosis vs. fatty liver etc History: transaminitis LIVER: The liver is enlarged measuring 20.1 cm cm in length. Increased echogenicity of the hepatic parenchyma is consistent with fatty infiltration. No focal hepatic lesion identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s. Hypoechoic area adjacent to the gallbladder likely represents focal fatty sparing. No surface nodularity of the liver to suggest cirrhosis.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Per ultrasound technologist, sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: Hypoechoic focus in region of pancreatic body is nonspecific on this ultrasound examination and may be further evaluated with dedicated cross-sectional imaging.SPLEEN: No significant abnormalities noted. The spleen measures 12.5 cm in length. RIGHT KIDNEY: Kidney measures 11.8 cm in length. Normal echotexture. No evidence of hydronephrosis or shadowing calculus.LEFT KIDNEY: Kidney measures 12.3 cm in length. Normal echotexture. No evidence of hydronephrosis or shadowing calculus.OTHER: No evidence of ascites.
1.Hepatomegaly with fatty infiltration of the liver. No definite evidence of cirrhosis.2.Nonspecific hypoechoic focus in the area of the body of the pancreas. Recommend dedicated cross-sectional imaging with IV contrast to further evaluate this lesion.