Male; 61 years old. Reason: Evaluate for HCC History: HCV, cirrhosis LIVER: The liver measures 15.2 cm in length. The parenchyma is mildly coarse in echotexture and heterogeneous. No focal hepatic lesion is identified.The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.2 m/sec.BILIARY TRACT: Cholelithiasis is again seen, there is no gallbladder wall thickening or pericholecystic fluid. The common duct measures up to 1.5 cm in diameter which is slightly increased compared to the prior ultrasound. There is no intrahepatic biliary ductal dilatation seen.PANCREAS: Again seen is a 2.0 x 2.0 x 1.2 cm peripancreatic lymph node (image time stamped 1:19:14 p.m.) this previously measured 1.7 x 1.4 x 1.1 cm. The head and body of the pancreas are unremarkable. The tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.0 cm in length.KIDNEYS: The left kidney measures 10.0 cm in length, the right kidney measures 9.2 cm in length. The cortex is normal in echogenicity bilaterally. There is no hydronephrosis or shadowing stone.
1.Mildly coarse liver parenchyma without focal lesion identified.2.Prominent peripancreatic lymph node may be benign and reactive in etiology in the setting of cirrhosis however would be better characterized on ERCP/MRCP if clinically warranted.3.Cholelithiasis without evidence of acute cholecystitis.4.Slight increase in extrahepatic biliary ductal dilatation. This would be further evaluated with ERCP/MRCP if clinically warranted. No intrahepatic biliary ductal dilatation delineated.