70-year-old male patient with cirrhosis. Evaluate for HCC and TIPS patency. LIMITED ABDOMENLIVER: The liver measures 14.4 cm in length and demonstrates increased, coarsened echogenicity. There is a new 2.4 x 2.2 x 2.5 cm hyperechoic lesion within the right hepatic lobe without significant vascularity on color Doppler imaging.BILIARY TRACT: The gallbladder contains scattered subcentimeter hyperechoic foci which may represent gallbladder polyps versus nonshadowing stones. There is no gallbladder wall thickening or pericholecystic fluid. No intra or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and proximal body of the pancreas demonstrate normal echogenicity. The remaining pancreas is visualized secondary to overlying bowel gas.SPLEEN: The spleen measures 20.5 cm in length. RIGHT KIDNEY: The right kidney measures 11.5 cm in length and contains a 1.3 cm inferior pole renal cyst. There is no evidence of hydronephrosis.OTHER: The left kidney measures 14.1 cm in length. No evidence of hydronephrosis.
1. Cirrhotic morphology of the liver with a new hyperechoic right hepatic lobe lesion; dedicated MRI of the liver is recommended for further evaluation.2. Patent TIPS and hepatic vasculature.3. Splenomegaly.4. Subcentimeter non-shadowing echogenic foci within the gallbladder may represent polyps vs non-shadowing stones.Finding 1. Communicated via phone to G. Reddy at 1358 hrs on 11/4/2015.