help understanding the jargon from ult... - British Liver Trust

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help understanding the jargon from ultrasound

Thumberlina profile image
20 Replies

Hi everyone, thanks for those who’ve offered advice and support this week to a newbie. It really does help you from assuming the worst.

I had my upper abdomen ultrasound today, arranged by myself after my GP told me there was nothing to worry about my bloods were fine. I went against the advice and booked this anyway for my own peace of mind.

The sonographer has recommended my doctor to carry out further investigation.

The comments on her report In summary were everything was normal with ducts and normal portal vein flow. Gallbladder etc all fine, pancreas obscured by bowel gas. It does state the liver is normal in size but contains 2 well defined hyper echo in areas, right lobe and left lobe. I am not looking for diagnosis, I understand.

I’m just looking for someone to tell me in laymans terms a) what it means and b) what do i need to ask my doctor in a follow up When I provide them it’s my results?

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Thumberlina profile image
Thumberlina
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20 Replies
AyrshireK profile image
AyrshireK

The sonographer isn't giving a diagnosis on the two wee defined hyper echoic areas and it is these that would require some follow up. They could be cysts or benign lumps like haemangioma, lumps of fat or even some scar tissue. You should take this report to your doctor and see about follow up, normally when an unidentified lump is found in the liver a follow up MRI scan would be booked to allow confirmation that it isn't anything to be concerned about. Everything else sounds good with nothing untoward. Maybe see if your doctor will arrange an MRI to see about these lumps but don't go terrifying yourself about them, there are more harmless lumps and bumps in livers than scary ones.

All the best, Katie

Thumberlina profile image
Thumberlina in reply to AyrshireK

THANK YOU SO MUCH Katie . Hopefully this will be enough for my GP to actually admit there is an issue now instead of fobbing me off and look to do something. I will push her now I understand more what I am dealing with.

Will keep you all in the loop. I’m 10lb lighter in a week, my appetite for anything went right out the window. Good kickstart to my healthy lifestyle, only 4 more stone to go :-)

AyrshireK profile image
AyrshireK in reply to Thumberlina

There still might not be an issue, many folks have lumps and bumps in their livers (particularly cysts) that cause no issues whatsoever so please don't convince yourself there is a problem but definitely worth getting investigated more thoroughly.

Katie

Thumberlina profile image
Thumberlina in reply to AyrshireK

I won't, I know a lot more about livers than I did this time last week that's for sure. Every "symptom" I've had has been treated in isolation, by different GP's and like you say may or may not be connected in any way but no-one has ever thought to put them all together.. It's the knowing. This at least gives me the confidence to question the GP and show I do have an understanding and push for the right investigation to be done. Thanks again Katie 🥰

Thumberlina profile image
Thumberlina in reply to AyrshireK

Hi Katie - so I had my call this morning and updated her on my diet and alcohol over the past few years. She has said even with the ultrasound, given all my blood tests she carried out and the liver test results she is convinced there is no underlying issue and I should carry on as normal and she wouldn’t investigate further.

Having pointed out to her my past symptoms which were all dealt with in isolation, she still wouldn’t budge on her opinion. I had an upper abdo ultrasound in 2015 which apparently showed on my right lobe 30mm which ii assume is the one now that’s over 50mm and said they put it down to being a haemangioma?

She said it was clear as I had booked the ultrasound privately that it is playing on my mind. However, given my results from the multiple blood tests she ordered she would not be in a position to refer me for a fibroscan as I don’t meet the criteria she has to work to?. I’m assuming cost is a deciding factor here?

She’s going to do AST and GGT tests and a full liver screen but earliest appt I can get is the 4th Dec. Can I push for the fibroscan or will these new tests provide a diagnosis even though I’ve not been physically examined or seen by anyone?

AyrshireK profile image
AyrshireK in reply to Thumberlina

If the previous scan had identified the hyper echoic regions as haemangioma then that's the only thing on your latest scan that would have required follow up i.e. if they are identified as haemangioma then they don't need checking to see if they are something more sinister. (My hubby has several and they are seen and identified on u/s).

With all normal tests and a clear ultrasound you should be reassured and hopefully with some follow up tests down the line you're getting an eye kept on you. Keep up the good work with your positive lifestyle changes and keep looking after your liver.

Katie

Thumberlina profile image
Thumberlina in reply to AyrshireK

That's reassuring, thank you Katie. She explained all about my white and red bloods, the clotting one and others too and said she wasn't just basing it on my LFT results but as we discussed in detail, nor was she considering alcohol as a potential factor...It did help I could throw in some terms and understanding and she could tell I'd done some research. Hopefully these next ones will give a clearer picture.

I can already feel all my symptoms easing and it's only been just over a week, that's enough to tell me I was doing myself damage. It's the haribo I'll miss more than the wine I think 🤗

Thumberlina profile image
Thumberlina in reply to AyrshireK

Hi Katie, out of interest could the 2 hyper echoic areas they found on my ultrasound actually be areas of steatosis? Would they look the same? Is it possible that the small one they found 5years ago was actually the start of it ? Will the MRI confirm either way?

AyrshireK profile image
AyrshireK in reply to Thumberlina

They could be, the MRI should be able to define what they are. My hubby had strange lesions turn up on his routine ultrasound a couple of years ago now and when he went for his follow up MRI it turned out that they were just some extra dense bits of cirrhotic tissue - he also has cysts and haemangioma and known cirrhosis. Hopefully you'll know more after your scan and the lumps will be just benign things. There are lots more benign lumps and bumps that can occur in the liver than there are scaries.

Best wishes for it.

Katie

Thumberlina profile image
Thumberlina in reply to AyrshireK

Thanks Katie, I wasn't sure if what she actually picked up was areas of steatosis or its fibrosis in my liver.

I have searched and fatty liver would apparently appear the same but cirrhosis usually wouldn't. Yet you can have alcohol cirrhosis and it not be apparent. The GP is also playing down and saying carry on as normal, yet has referred me to the liver specialist who has ordered an MRI with contrast. It's not for another 4 weeks and then the follow up not until 2nd march. It's all very confusing 🥺

hells456 profile image
hells456 in reply to Thumberlina

It's probably due to patient need, not cost as there aren't that many machines around. I was referred with my bloods 8x maximum and mildly yellow and was told for urgent cases like me it was a 6 month wait.

Thumberlina profile image
Thumberlina in reply to hells456

I was told they apparently have parameters set to them. As my LFT to them was in the acceptable range it didn’t warrant a referral. Equally, as I paid for my own, they won’t accept the results or allow me to send them copies of the images.

Chris884 profile image
Chris884 in reply to AyrshireK

Got a question. Where do spider angiomas appear in cirrhosis.

AyrshireK profile image
AyrshireK in reply to Chris884

On the British Liver Trust page on cirrhosis it says spider angioma are an early symptom of cirrhosis "spider-like small blood capillaries on the skin above waist level (spider angiomas)". Some people though do get confused with spider veins/thread veins which are nothing to do with cirrhosis and spider angioma which can be related to liver disease (these actually look like little spiders with a central body and legs running off.

Have you had a confirmation of cirrhosis diagnosis Chris? I know you've posted a couple of times over the years and were having difficulty getting proper tests.

Katie

Chris884 profile image
Chris884 in reply to AyrshireK

No have always had normal ct scans. But since I lost insurance. Just been worried about any little thing I see. I am a welder stand 10-12 hours a day. And have noticed spider vein things on legs and on upper thighs I have a couple of red dots. I guess when doctors tell you scans show liver appears normal. I still worry because have not been to doctors in a few years.

AyrshireK profile image
AyrshireK in reply to Chris884

We've communicated before Chris, I am aware of your story. It sounds like these are thread veins which arn't the same as spider angioma which as the BLT page suggests are normally above waist level in liver disease. I know my hubby only has 2 true spider angioma and he has confirmed cirrhosis - his are on the rear of his shoulders. It's a great pity you are still not in a position to get proper monitoring after your hep c treatment.

Katie

Chris884 profile image
Chris884 in reply to AyrshireK

I appreciate it. I am working on getting insurance.

Chris884 profile image
Chris884 in reply to AyrshireK

I got a quick question every lab I get done always shows ast normal and alt normal range but ast number is always larger than alt but both are in normal ranges. When I do ratio mine is 2.0 on my test but the cut off limit is 2.2 does ratio matter if both are in normal ranges

hun64_D0chIk profile image
hun64_D0chIk

Hi Thumberlina, you don’t mention what your physical symptoms are which were dealt with by different GP’s in isolation. What are they?I can only tell you that for me, I didn’t get a Fibroscan until I’d been referred from the GP to a Gastroenterologist at a London hospital then she referred me to a Hepatology Consultant at their parent Trust Hospital. It was the Hepatology Consultant who arranged with a nurse to do the Fibroscan. However, as discussed on this BLT forum it can vary and be one reading then another (this happened to me) and in my opinion because this happened to me it’s not a reliable diagnostic measure of cirrhosis.

Your GP giving you Liver Function Tests (LFT’s) with a GGT test will give her a chance to review and hopefully provide you with the answers you’re looking for.

Keep us updated. Good luck with your new health regime. I love Haribo Tangfastics ;)

Hundochick

Thumberlina profile image
Thumberlina

Hi guys- update......GP spoke to liver team re my ultrasound results and she has referred me to a liver specialist who’ve organised an MRI for 28th January, as the masses had no blood flow they don’t believe them to be cysts so want to investigate further. Hopefully should get some answers. Follow up with him not til March but least the ball is rolling 😬

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