History of elevated AST/ALT. Question of cirrhosis. LIVER: The liver is mildly coarse and echogenic. There is subtle mild left lobe hypertrophy, however the capsule is smooth. The liver measures 21 cm in craniocaudal dimension. No focal lesion is identified. No intrahepatic biliary ductal dilatation.BILIARY TRACT: Normally distended gallbladder with sludge. No gallbladder wall thickening, gallstones, pericholecystic fluid or focal tenderness. No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm.PANCREAS: The visualized portions of the pancreatic head and body are unremarkable. The remainder is obscured by overlying bowel gas shadowing.SPLEEN: The spleen is normal in size, measuring 11.4 cm length without a focal lesion.RIGHT KIDNEY: The right kidney measures 11.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 11.6 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. Color Doppler demonstrates hilar blood flow.
Mildly coarse and echogenic liver may represent parenchymal dysfunction and/or fatty infiltration. Possible early changes of chronic liver disease without definite changes of cirrhosis or portal hypertension. No suspicious liver lesion.