new ultrasound report

[scotty2canuck]

Hi Dr,

Nov 08 - ultrasound 12mm hypoechoic liver nodule segment 4b
Dec 08 - MRI with and without contrast - liver normal (other than 14mm fatty area that did not corrospond to hypoechoic nodule)

Feb 09  - ultrasound finding - "subtle echo poor lesion 12mm in the left lobe with somewhat bullseye apperance due to slight central ecogenicity.   This is a subtle and non specific finding"   Follow-up in 6-8months with MRI.

What does this mean - am scared that it could indicate something bad like metasteses (I have no known cancer but of course had to look on the internet and found that this bullseye sign is sugestive of this.

Also is 6-8 months reasonalbe time to wait for follow-up.

i appreciate your help here.

thanks

[Thomas D Schiano, MD]

ultrasounds are not very reliable as they are operator-dependent.  My gut sense is that this is nothing wrong because the MRI is OK.  i would repeat a CT scan or MRI in 3-4 months

[scotty2canuck]

Thank you for you insight.  My Dr did send me for further MRI to compare with the new ultrasound results.  

MRI of March 02 findings are:

"Mild subcapsular fatty infiltration of the medial and lateral segments of the left hepatic lobe adjacent to the anterior aspect of the falciofrm ligament.  Otherwise, no hepatic lesions or focal abnormalities are seen"

Is it common for ultrasound to show liver lesion and MRI (two in my case) to miss it????

Could the fatty involvment be involved in the anomaly in the ultrasound????

Any thoughts on what i could be look at here?

Also, am currently only followed by family doctor - would a file review (reports and images) be indicated here?   if so how do i access this (I am in canada, though have had my MRI in the states).

thank you kindly

[Thomas D Schiano, MD]

mri are much mores ensitive than U/S so this is the better study so don't worry about it missing anything (I presume that you received IV contrast). I think you should definitely have a hepatologist look at the images.