Male 78 years old; Reason: cirrhosis -- assess for hepatoma History: some weight loss LIVER: The liver measures 17.3 cm in length. There is heterogeneous increased echogenicity of the liver parenchyma. The liver is coarse and nodular in appearance. The main portal vein is patent with normal hepatopetal flow measured at 27.9 cm/s. Numerous anechoic cysts are revisualized from prior ultrasound without significant change. Small hyperechoic foci seen on prior ultrasound are not redemonstrated on this study.GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 1.8 mm. Several small echogenic stones are seen along with a small amount of layering sludge. No pericholecystic fluid. The common bile duct measures 2.5 mm in diameter. There is no intrahepatic ductal dilation.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 10.8 cm and no significant abnormalities are noted. A small splenule is revisualize superiorly.RIGHT KIDNEY: The right kidney measures 8.4 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen. Very small renal cysts are visualized from prior ultrasound.LEFT KIDNEY: The left kidney measures 8.8 cm in length. The cortex has increased echogenicity. No hydronephrosis, stones, or worrisome masses are seen. A renal cyst is revisualized superiorly measuring 4.3 cm x 2.4 cm x 3.5 cm. Another anechoic cyst is seen at the lower pole measuring 3.8 cm x 2.5 cm x 3.6 cm.ABDOMINAL AORTA: The abdominal aorta is patent with appropriate directional flow and peak systolic velocity of 75.7 cm/s. The proximal portion of the abdominal aorta was measured 2.0 cm x 2.4 cm. The midportion which measured 1.9 cm x 1.6 cm. The distal portion was measured 2.9 cm x 2.2 cm.INFERIOR VENA CAVA: The IVC is patent with hepatofugal flow.ILIAC ARTERIES: The bilateral iliac arteries are patent with appropriate directional flow. The left iliac measures 1.4 cm x 1.1 cm. The right iliac measures 1.4 cm x 1.4 cm.OTHER: The bladder is visualized without any significant abnormalities noted.
1. Cirrhotic morphology is again redemonstrated with scattered small hepatic cysts as seen on prior ultrasound. Small echogenic foci seen on prior ultrasound were not revisualized on this study. No new worrisome masses are seen within the liver.2. Cholelithiasis without overt sonographic evidence of acute cholecystitis.3. Bilateral echogenic kidneys compatible with medical renal disease.4. The distal portion of the abdominal aorta has mild aneurysmal dilatation measuring 2.9 cm x 2.2cm.