53-year-old female patient with elevated LFTs, alkaline phosphatase. Evaluate for biliary, gallbladder, liver pathology. LIVER: The liver measures 14.8 cm in length. There is a 1.1 x 1.3 x 1.0 cm hyperechoic lesion within the inferior right hepatic lobe. An additional ill-defined area of hyperechogenicity is noted within the left hepatic lobe measuring approximately 1.5 cm. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 4 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9.5 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 11.6 cm in length. No evidence of hydronephrosis. There is a 1.0 x 1.0 x 0.8 cm hypoechoic lesion within the left midpole.The spleen measures 8.7 cm in length.
1. Right inferior hepatic lobe hyperechoic lesion and region of hyperechogenicity within the left lobe which are incompletely evaluated on this evaluation; given prior imaging findings and history of cancer, dedicated liver CT/MRI is recommended for further evaluation.2. Hypoechoic left midpole lesion is indeterminate. 