Answers
What do the words in my ultrasound report mean?
Short answer
Ultrasound reports use words that can sound alarming. Many findings, such as a liver haemangioma, a simple liver cyst or a slightly bulky pancreas, are common and harmless. Others, such as coarse liver texture, an enlarged spleen or a dilated bile duct, need follow-up. Always read the report together with your symptoms and blood tests.
Liver
- Fatty liver or 'increased echogenicity': fat in the liver; see our page on fatty liver grades
- Hepatomegaly: the liver is larger than average; often from fatty liver, sometimes from infection or other causes
- Coarse echotexture or irregular surface: may mean long-standing liver damage or cirrhosis, and needs blood tests and a FibroScan
- Haemangioma: a common, harmless knot of blood vessels; usually needs no treatment
- Simple cyst: a fluid bubble, harmless when it is 'simple' (thin wall, clear fluid)
Gallbladder and bile ducts
- Gallbladder sludge: thick bile, seen after fasting, in pregnancy or with rapid weight loss; often clears on its own but can cause pain or pancreatitis
- Contracted or poorly seen gallbladder: often just means you had eaten before the scan
- Thick gallbladder wall: can be from inflammation, liver disease or, rarely, cancer; your doctor decides on further tests
- Dilated or prominent bile duct (CBD): can be normal after gallbladder removal or with age, but with jaundice or abnormal liver tests it needs MRCP or EUS
Pancreas and spleen
- Bulky pancreas: often a normal variation, especially in young people; it matters only with pain or raised lipase
- Poorly seen pancreas: common, because gas in the bowel hides it
- Splenomegaly: an enlarged spleen; causes include infections such as malaria, liver disease with high pressure in the portal vein, and blood disorders
- Free fluid: fluid in the belly (ascites), which always needs the cause found
What to do next
Take the report to your doctor along with your liver tests. Many findings need nothing more. Findings that usually need a specialist review: coarse liver texture, a liver lump that is not a simple cyst or typical haemangioma, a dilated bile duct with jaundice, splenomegaly, free fluid, or a gallbladder polyp of 6 mm or more.
Before your next ultrasound
Before the scan
- Do not eat for about 6 hours before an abdominal ultrasound, unless told otherwise
- Water is usually allowed; some scans need a full bladder
- Bring your earlier reports and blood tests
Avoid
- A meal before the scan, which contracts the gallbladder and fills the bowel with gas
- Fizzy drinks and chewing gum on the morning of the scan
- Comparing reports from different centres without your doctor
Good to know
- Gas in the bowel often hides the pancreas; this is common and not a disease.
- Most incidental findings need no treatment, only an explanation.
Common questions
My report says 'hepatomegaly'. Is my liver diseased?
Not necessarily. Liver size varies with body size and is often slightly large with fatty liver. Your doctor reads it together with your blood tests.
Does a liver haemangioma turn into cancer?
No. A typical haemangioma is harmless and does not turn into cancer. Very large ones causing pain are occasionally treated.
Should gallbladder sludge be operated on?
Usually not, unless it causes pain, pancreatitis or gallbladder inflammation. It often clears with regular meals.