71-year-old male with known liver mass and abnormal liver function. LIVER: There is again noted a mildly heterogeneous, lobulated and echogenic mass or masses in the right hepatic lobe measuring approximately 7.6 x 10.8 x 10.4 cm, unchanged from prior exam. In the left hepatic lobe there is a similar-appearing 2.1 x 2.6 x 2.1 cm mass not definitely visualized on prior exams. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein. However, main portal vein velocity is low at 9 cm/s which may be related to portal hypertension.GALLBLADDER, BILIARY TRACT: Gallbladder is adequately visualized and contains dependent sludge. There are several small echogenic foci within the sludge which may represent very small gallstones.The wall is mildly thickened but this is nonspecific in the face of ascites. No diffuse biliary tract dilatation. PANCREAS: Not visualized due to bowel gas.RIGHT KIDNEY: Limited without hydronephrosis.OTHER: Mild ascites not seen on prior exams.
Large right lobe hepatic masses again identified as well as a smaller left lobe mass.Dependent sludge in gallbladder with possible small stones. Gallbladder wall thickening is seen but nonspecific in face of ascites.