Liver Transplant Expert Forum
Dr Shiano ...part 2
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Dr Shiano ...part 2

Had my US done in 8-2012.  The US Final report stated that the liver was MILDLY hetergeneous echogencity.  A liver cyst with small indentations.  No acites (ascites). Spleen normal sized.  Kidneys normal that can be visualized. GB normal..pancreas normal.

BUT .. I had to get a CD made for the hep I will be seeing in April and was looking thru that cause I wanted to see the size of the cyst.  Came across the Loosy report which is the worksheet the dr reading the US jots down the info from his reading of the US.  

His report states: DIFFUSELY hetergeneous liver (fatty liver is circled)... COMPLRX CYST 2.3 x 2.1 x 2.1  

Aorta P - 2.3 cm

SPLEEN ENLARGED - 13.8 x 4.8 x 4.9   US didnt state this and said it was normal..  

Also US stated no acites (ascites) but the bottom of the report doesnt have it marked

AND has FLUID COLLECTION (either wrote VS or IS) artifact midline.  12.0 x 8.9 x 4.5 cm.

AND the worksheet states that there is dilated duct(s) at pancreas head.  ????  Nothing else noted.Is this a concern?

So..the two reports dont match.  There are some discrepancies.  
Anyone know much about what the dr who read the report is seeing?  Somehow the same thing didnt get translated on the Final US Report.  

I called the gastro and told him I was going to come in with the cd.  .  

Thank you

Paula
517301_tn?1229801385
i think that you need a good MRI or CT scan as there is a lot of operator-dependency with ultrasonography
9 Comments
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89592_tn?1391278022
Dilated duct(s) at pancreas head ..the last word I could finally make out is edema..    Thank U..
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89592_tn?1391278022
1) Is this very concerning to you?  My bloodwork is really not bad...the CMP has been pretty good with and my meld had been 6 or 7

2) what is better MRI or CT  
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89592_tn?1391278022
Oh yes...and I had ANA done for lupus....  
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517301_tn?1229801385
either CT scan or MRI are fine.  I dont think an U/S is adequate to evaluate the pancreatic head area.  I am confident that it is nothing to worry about.
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89592_tn?1391278022
Thank you.  took the cd to my pcp and came back into the room..said that diffuse is same as mild.  The panceatic edema is from the cyst...complex.  That the spleen is normal at 13.8. He is not sure if i have acites (ascites) since it could be the artifact midline...and not fluid collection..that was questionable.  I am going to get another US next week to see if the cyst has grown.....so that is good. Hope it stays stable.  I'm sure I will be getting a CT scan soon when I see my new hep at CC.

Thank you for taking the time to talk to me and to others who have so many questions, no answers, maybe no insurance and are very scared.  We all apprecuate having you and those on the cirrhosis forum to speak to.  

Thanks again so very much!!  Paula  OH
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517301_tn?1229801385
good luck.  The CT scan will be most revealing.
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89592_tn?1391278022
Thank you.  I changed my US to Monday and will ask about the ct scan.  I  need a pre auth for that to be done.

What is the chance foir a complex cyst to be cancerous?  It was 2.3 x 2.1 x 2.1  6 mos age.  couple sm areas of indentation,  

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517301_tn?1229801385
probably 10%
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517301_tn?1229801385
Thomas D Schiano, MDBlank
The Mount Sinai Medical Center
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