Elevated ALS and AST Now Hypoechoic lesion.

I had elevated ALS 88 and AST 65. So They test me for hepatitis and that came back clear. So the doctor sent me to get a ultrasound sound done

The Finding was Diffusely increase echogenicity of the lever suggesting fatty infiltration. Multiple relatively hypoechoic lesion are seen within the right Hepatic lobe, Largest of which measures approximately 2.2 x 1.7x 2.5 cm adjacent to the gallbladder fossa. Finding may represent focal areas of fatty sparing.

IMPRESSION: Fatty infiltration of the liver and multiple hypoechoic lesions in the right hepatic lobe. Finding may represent focal areas of fatty sparing. Consider futher evaluation with dedicated MRI liver mass protocol, to include in and out oh phase imaging and postcontrast images.

Is this serious I don't know what to do?

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Ultrasonically, increased echogenicity can happen if there is a fatty liver. Usually this is uniform echogenicity. Hypoechoic (less echogenicity) lesions as mentioned could be due to the normal liver between the fatty liver changes. Others which can cause similar pictures are tumors, cysts and sometimes hemangiomas. An MRI may help diagnose the cause. If there is a doubt then a liver biopsy may be needed. Again a follow up may be mandatory to see for changes in the lesion.

Hope this helped and do keep us posted.