35 year old female with a history of mild transaminitis and concern for NASH. LIVER: The liver parenchyma is coarsened and increased in echogenicity. Normal hepatic contour and morphology. Increased echogenicity limits evaluation for a small focal lesion. Given this limitation, no focal hepatic lesion is evident. The liver is normal in size, measuring 20 cm in craniocaudal dimension. There is no intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.GALLBLADDER, BILIARY TRACT: No extrahepatic biliary ductal dilatation with the common duct measuring 3 mm. There are small layering gallstones without wall thickening, pericholecystic fluid, or focal tenderness.PANCREAS: The visualized portions of the pancreatic body and head are normal.RIGHT KIDNEY: The right kidney measures 13.3 cm in length without hydronephrosis, shadowing nephrolithiasis, or focal lesion evident.OTHER: The left kidney is normal in size, measuring 13.2 cm without hydronephrosis or focal lesion evident. There is an approximately 8mm collecting system shadowing calculus. The spleen is normal in size, measuring 11.4 cm.
1. Coarsened and increased hepatic echogenicity compatible with diffuse fatty infiltration/NASH. No focal hepatic lesion is identified.2. Cholelithiasis without evidence of acute cholecystitis. 3. Nonobstructive left renal collecting system 8-mm calculus.