67-year-old male patient with history of HCV. HCC screening. LIVER: The liver measures 11.8 cm in length and demonstrates coarsened hepatic echotexture. There is a new 1.9 x 1.3 x 2.1 cm area of hypoechogenicity within the left hepatic lobe which appears to be bulging the liver contour; this is not seen on prior CT. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There are no gallstones, gallbladder wall thickening, or pericholecystic fluid. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 2 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 9.1 cm in length. No evidence of hydronephrosis. OTHER: The left kidney measures 9.3 cm in length. No evidence of hydronephrosis.The spleen measures 9.0 cm in length.
1. Hypoechoic lesion within left hepatic lobe concerning for HCC; dedicated contrast enhanced CT/MRI of the liver is recommended further evaluation.2. Coarsened hepatic echotexture consistent with chronic liver disease.