Hi... I recently had a abdominal ultrasound performed for the 2nd time in 4
years. The first time I had one the Dr. told me I had a fatty liver because
the ultra sound showed "hepatic parenchyma is markedly echogenic". I have
had negative hepatitis panels (for A,B, and C) and still do. This most
recent ultrasound read as follows:
Supine and decubitus views of the gallbladder were obtained. There is no
evidence of cholelithiasis,gallbladder wall thickening,pericholecystic
collection or biliary dilatation. The enitre live parenchyma is markedly
echogenic and difficult to completely visualize because of its increased
density. In the left lobe, however, there are two focal areas of different
echo texture. One is a tiny cystic structure measuring 8mm. in size
anteriorly and inferiorly in the left lobe of the live. The second focal
area is solid and of decreased echo texture when compared with the
surrounding parenchyma. It is 1.1 x 1.2cm. in size.  (Then the rest of the
report talks about how everything else looks normal). The impression read:
Markedly echogenic hepatic parenchyma. This may be seen with generalized
fatty infiltration,Inflammatory state such as hepatitis, or other
infiltrative processes. There is no evidence of biliary dilatation or
cholelithiasis. In the left lobe of the liver, there is a tiny cyst,however,
there is a focal solid lesion noted. This echo texture in itself is in
contrast to the surrounding echogenic parenchyma. specificity in this
setting of the etiology of this lesion is not determined. (Then it ends by
stating that they would recommend a spiral ct to determine what this 2nd
lesion is).
Well, needless to say I'm now scared to death. Does hepatic cancer generally
present in an ultrasound as a "solid with decreased echo texture"? What else
could this be??? If it is a cancer, would it's size make it easier to cure?
Thanks for any help
J.D.

(snip)

This pattern sounds more like a primary liver disease -- cirrhosis,
hepatitis, etc. rather than cancer. It might be a simple problem that
requires no treatment-- but then again it might be serious. I would
suggest an evaluation by a specialist in gastroenterology and/or
hepatology.

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