Female; 67 years old. Reason: hep c screen for hcc History: same LIVER: The liver measures 18.8 cm in length. The liver contour is smooth, the parenchyma is mildly increased in echogenicity. No hepatic mass is identified. The main portal vein is patent and demonstrates hepatopetal flow with peak velocity of 0.39 m/sec.BILIARY TRACT: The gallbladder is contracted. There is no pericholecystic fluid, sonographic Murphy's sign was not elicited. The proximal common bile duct is prominent measuring 9 mm, increased from 7 mm seen on April 2010 ultrasound study. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 7.1 cm in length.RIGHT KIDNEY: Right kidney measures 10.3 cm in length. The cortex is increased in echogenicity. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 9.5 cm in length. The cortex is increased in echogenicity. A hypoechoic structure in the superior pole measures 1.1 x 1.3 x 1.1 cm and contains internal echoes and is heterogeneous. This was not definitely seen on the prior sonographic studies. There is no hydronephrosis or shadowing renal stone.
1.Hepatomegaly. Mildly echogenic liver suggestive of parenchymal dysfunction. 2.No hepatic mass.3.Bilateral echogenic kidneys compatible with medical renal disease.4.Prominent proximal common bile duct, correlation with patient's clinical history and laboratory values recommended, if there is clinical concern for choledocholithiasis, MRCP or ERCP is recommended.5.1.3 cm hypoechoic left renal structure is indeterminate. Contrast enhanced CT or MRI is recommended for further evaluation.