63-year-old female patient with HCV, cirrhosis. Evaluate for HCC. LIVER: The liver measures 16.9 cm in length, demonstrates coarsened echogenicity, and is nodular contour. There is a 1.2 x 1.0 x 1.0 cm hypoechoic lesion within the right hepatic lobe dome. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are gallstones without gallbladder wall thickening or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 3 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 10.7 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 10.8 cm in length. No evidence of hydronephrosis. There is a 1.1 cm left midpole renal cyst.The spleen measures 8.5 cm in length.
1. Cirrhotic morphology of the liver with a right hepatic dome hypodense lesion; dedicated contrast enhanced liver CT/MRI is recommended for further evaluation.2. Cholelithiasis without sonographic evidence of acute cholecystitis.