Male 65 years old; Reason: assess for AAA. Also follow up lesion seen on 2008 CT scan dome of liver History: "buzzing in abdomen" and pulsatile aorta on exam LIVER: The liver measures 14.8 cm in length. There is increased echogenicity of the liver parenchyma. Several anechoic cyst are seen throughout the liver. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow measured at 19.9 cm/s. At the dome of the liver there is a hyperechogenic lesion measuring 3.5 cm x 1.9 cm x 2.7 cm this corresponds to the liver dome lesion seen on the prior CT in 2008. On the CT this is measured 3.2 cm x 2.8 cm.GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 2.2 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 3.4 mm in diameter. PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 9.4 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 11.9 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen. The renal cyst is seen at the inferior pole measuring 2.6 cm x 2.8 cm x 2.2 cm.LEFT KIDNEY: The left kidney measures 12.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: The bladder is visualized without any significant abnormalities.DOPPLERS:ABDOMINAL AORTA:Proximal: 2.4 cm in AP dimensionMid: 2.0 cm in AP dimensionDistal: 2.1 cm in AP dimensionAt the mid abdominal aorta flow is patent and appropriately directional with peak systolic velocity of 73.3 cm/s.ILIAC ARTERIES: Right common iliac artery measures 1.3 cm, the left iliac artery measures 1.1 cm.
1. There is increased echogenicity of the liver compatible with fatty infiltration/hepatocellular dysfunction. There are several subcentimeter cysts seen within the liver.2. Hyperechogenic focus in the dome of the liver may represent a hemangioma, but appears stable in size from prior CT. This could be further evaluated with MRI.3. The abdominal aorta is nondilated.