Help with liver issue please

[scotty2canuck]

Dear Dr,

thank you for you prior assistance.  To summarise in Nov an u/s showed a 1cm hypoechoic liver nodule left lobe,  MRI in december showed 14mm focal fatty infiltration in the subcapsular region  adjacent to the falciform ligament that did not corrospond to the u/s nodule.   U/s in feb showed 1cm hypoechoic nodule with somewhat bullseye apperance due to a slight area of increased echonicity (?) the finding was classed as subtle and in the left lobe in either the medial or lateral segment.   MRI later in Feb found no focal liver lession but "mild subcapsular fatty infiltration of the medial and lateral segment of the left hepatic lobe adjacent to the anterior aspect of the falciform ligament".

1.  should i be concered that u/s continues to show nodule but MRI does not???

2.  is a CT scan necessary - I would prefer to avoid the exposure to radiation.  Is the MRI a better modality of imagin in this instance than CT??????

3.   What should be done for follow up.

I am realy worried re this so your input would be greatly appreciated.

thanks

[Thomas D Schiano, MD]

i am not too concerned about the spleen size.  these small increments in size are not too large.  Again, i wouldn't follow them solely with ultrasonography.

[siobhanmh]

sorry in the above post i meant the liver nodule was 1.2cmx1cm   and now 1.4cmx1.2cm

thanks

[siobhanmh]

Dear Dr,

I hope this finds you well.  Thank you very much for all your help to date.   I have just had a follow up u/s to check on gallbladder polyps and liver nodule...  No issue noted with the polyps.   Liver nodule measuring 1.2mmx1.4mm  and spleen 13.4cm.      u/s in Nov 08 and then in Feb 09 it measured 1.2mmx1.0mm.  each time u/s were done by different technican and different machines.   MRI in dec 08 and feb 09 - no focal mass seen.

is a 2mm change in ultrasound measurment a concern???

does the spleen enlarge and return to normal?????  it has previously been normal???

what is the best course of action for follow up and when????

i am 35yrs and female.


thank you

[Thomas D Schiano, MD]

I think MRI is always more sensitive than U/S, which is operator-dependent.  MRI provides no radiation and is equal to CT scan in sensitivity so would get that done.