60-year-old female presents with transaminase. Evaluate hepatic vasculature. LIVER:The liver measures 14.8 cm. There is increased, coarse, and heterogeneous echotexture. No masses, ascites, or intrahepatic biliary dilation.GALLBLADDER, BILIARY TRACT: The gallbladder does not appear distended. The gallbladder wall measures 0.2 cm. The common bile duct measures 0.4 cm. There is an approximately 1.3 x 0.9 cm echogenic focus most likely representing a stone within the gall bladder. No pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: Evaluation of the pancreas limited by overlying bowel gas.SPLEEN: The spleen measures 7.1 cm. No significant abnormalities are noted.KIDNEYS: The right kidney measures 10.0 cm. The cortex has increased echogenicity. No shadowing calculi or hydronephrosis. The left kidney measures 9.1 cm. The cortex has increased echogenicity. No shadowing calculi or hydronephrosis. ABDOMINAL AORTA: Patent without aneurysm.PORTAL VENOUS: The portal vein is patent with normal hepatopedal flow. The peak velocity is measured at 17.0 cm/s. The right portal vein is patent. The left portal vein is patent.HEPATIC ARTERIES: The hepatic arteries are patent.INFERIOR VENA CAVA: Patent without thrombus.OTHER: There is a small right-sided pleural effusion.
1. Increased, coarse, and heterogeneous echotexture of the liver consistent with chronic liver disease/parenchymal dysfunction. No masses or ascites.2. Echogenic kidneys consistent with medical renal disease/parenchymal dysfunction.3. Cholelithiasis without signs of acute inflammation.4. Small right-sided pleural effusion.5. Patent hepatic vasculature.