55-year-old male with a history of heart failure and lower extremity edema. Evaluate for cirrhosis. LIVER: The liver is mildly coarse and increased in echogenicity. It is normal in size, measuring 16.4 cm. The liver morphology is normal. No focal hepatic lesion or intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 30 cm/sec.GALLBLADDER, BILIARY TRACT: Normally distended gallbladder without gallstones, wall thickening, focal tenderness or pericholecystic fluid. No extrahepatic biliary ductal dilatation with the common duct measuring 6 mm.PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.RIGHT KIDNEY: The right kidney is normal in size, measuring 10 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident. Increased cortical echogenicity.OTHER: The left kidney is normal in size, measuring 12.9 cm without hydronephrosis, shadowing nephrolithiasis or discrete lesion evident. Increased cortical echogenicity.The spleen is normal in size, measuring 11.2 cm.
Coarsened and increased hepatic echogenicity likely related to diffuse fatty infiltration. No focal hepatic lesion or specific findings of cirrhosis.Medical renal disease.