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What Does This Ultrasound Report Indicate?

Posted on Wed, 9 Nov 2016

Question: Hi, i am 26 yrs old male not obese . was diagnosed with diffuse fatty liver change before 10 months . in that time i did ultrasound and showed diffuse fatty liver. my blood work was all normal in that time Only ALT 52 and cholesterol 209. did testing for hep A,B,C all negative . i stopped drinkingalcohol and eat little bit healthy food from time to time . i did another blood work last week shows all numbers normal , but ALT 63 and cholesterol 253. i never experienced any symptoms but only slightly pain on my right abdomen 3/10 after i eat heavy meals. i did ultrasound last week and it goes like this :
EXAM: ULTRASOUND ABDOMEN COMPLETE

HISTORY: Fatty liver

TECHNIQUE: Standard grayscale images were acquired with additional Doppler interrogation when appropriate.

COMPARISON: None available.

FINDINGS:

Liver: Nonspecific slight heterogeneous liver echotexture without mass depicted. The liver measures 12.9 cm in length.

Gallbladder: Normal.

Bile Ducts: Intrahepatic and extrahepatic bile ducts are not dilated. The common bile duct measures 0.4 cm diameter.

Pancreas: Unremarkable.

Spleen: Normal echotexture. The spleen measures 8.6 cm in length.

Aorta: Visualized portions appear normal. IVC venous flow suggesting patency. Portal vein shows hepatopetal flow direction and normal size.

Kidneys: No pelvicaliceal dilatation. No stones. The right kidney measures 9.2 cm in length. The left kidney measures 9.6 cm in length.

Ascites: None. No pleural effusion depicted.

IMPRESSION: Nonspecific mild heterogeneous echotexture of the liver.

Unremarkable study otherwise. Correlation with clinical and laboratory data needed.

What does " Nonspecific slight heterogeneous liver echotexture without mass depicted " mean ? and what is the difference between first and second ultrasound .. Do i still have fatty liver? Is there any enlargement in the liver ?
Thank you in advance ..

Answered by Dr. Dr. Klerida Shehu (10 hours later)

Brief Answer:
please follow...

Detailed Answer:
Hi and thank you for asking on HCM.
I read carefully all your concerns and I can say as follows:
1. You are reporting to have ALT 63 recently and cholesterol 253.
Your ALT level is mildly elevated , it may be related with fatty liver and high cholesterol level.
2. To my opinion you need to start the treatment with statins for high cholesterol level plus healthy diet.
3. With regards to liver description made on ultrasound it means that your liver is not homogenous but there is nothing to be worried. Both ultrasounds means the same finding but expressed in different words.
Otherwise I need to know if it Is the same physician that made both ultrasounds or different?
To my opinion you continue to have fatty liver even it is not enlarged.
If you can send me the report of the first abdominal ultrasound it would be great.
Hope it was helpful to you.
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (2 hours later)

Hi thank you for replay , i already upload report for the first ultrasound .
Yes i did ultrasound in two diffrent facilities.
Can you please review and give me your opinion. I have concerns because it doesnt say anything about fatty liver . I dont know what are stains but is it a lifetime medication? And i did abstain from fast food and alcohol for 10 months . Can you please give me your opininon on consuming alcohol in moderation . ( like once or twice drink per weekend ). And is there any patient that have my condition at my age :( . And how serious it is . Thank you ..

Answered by Dr. Dr. Klerida Shehu (10 hours later)

Brief Answer:
Please follow...

Detailed Answer:
Hi back,

I review you abdominal ultrasound report and i can say that it is the same but expressed in different words.
But I can say that the second ultrasound describes your liver better than the firs one.
It means that you have improvement of fatty liver. On the other hand if you are concerned about liver fibrosis than You can perform fibro-scan which will better rule out fibrosis of your liver.
Otherwise since you have elevated ALT level I would recommend you to quit alcohol at least 8 weeks and after that you should repeat AST and ALT level.

There are a lot of patients in my clinical practice at your age with such issues.
It is not a serious conditions but need to take care of your diet which means to:
- stop alcohol use
- use vegetables and fresh fruits
- avoid fatty foods
- use fish or chicken meat
- increase physical activity and try to loose weight.
Hope it was helpful to you.
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (6 hours later)

Thanl you for your answer ,

i forgot to mention that i did a fibroscan on April, after 3 months of first ultrasound . it gaves me 3.4 Kpa . a higher reading was 4.1 once.
Thank you

Answered by Dr. Dr. Klerida Shehu (18 hours later)

Brief Answer:
Please follow..

Detailed Answer:
Hi back,
Thank you for giving more of your medical data.

If fibroscan shows score maximum level of 4.1 Kpa, it is within normal range.
It means that you don't have liver fibrosis.
DON'T WORRY, it is only fatty liver.

Hope it was shelpful to you.
Dr.Klerida

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar