FINDINGS:

Exam Notes Transabdominal scanning was performed of the right upper quadrant including the liver, gallbladder and biliary tree, pancreas and right kidney.

Liver The liver is normal in morphology. The liver is normal in size by subjective and objective criteria (being less than 13cm in the mid-clavicular line and less than 16cm in the mid-hepatic line). The main portal vein is patent and demonstrates antegrade flow.

The liver echogenicity is increased. Degree: mild.

The liver is diffusely heterogenous with multiple areas of increased echogenicity. The outside reported hemangioma is not discretely seen on this ultrasound. Technologist notes a hyperechoic area in the posterior right lobe with ill defined borders that was not discrete enough to measure in 3 planes, possibly related to the reported hemangioma.

Lesion #1: Current size: 1.3 x 1 x 1.2cm. Location: right lobe. Composition: solid appearing. Border: well circumscribed. Blood flow by color Doppler is: absent.

Gallbladder The gallbladder is normal in size (less than 10cm by 5cm) and appearance.
There are no shadowing gallstones, pericholecystic fluid, wall thickening (greater than 3mm) or sonographic Murphy's sign.

Biliary Tree The common bile duct is normal in caliber measuring 3 mm measured at the porta hepatis. (The normal mean diameter of the common bile duct is 6mm up to age 60 and increases 1mm per decade thereafter. In the absence of the gallbladder, the common bile duct can measure up to 10mm diameter secondary to physiologic reservoir phenomenon.)

There is no intrahepatic biliary ductal dilation.

Pancreas The visualized portion of the pancreas is unremarkable. Pancreatic duct measures less than 3mm.

Right Kidney The right kidney measures 10.3 cm. The right kidney is normal in size and echogenicity. No masses are identified.
No renal collecting system dilation or shadowing renal calculi are seen.

IMPRESSION:

• Hepatic steatosis with heterogenous liver parenchyma. The outside reported hemangioma was not definitely seen on the provided images.
• Solid non-specific liver mass(es) as described above. Recommend correlation with prior outside MRI. If this unable to be performed, further evaluation with repeat MRI of the abdomen without and with IV contrast is recommended.