What is a normal-sized liver with increased parenchymal echogenicity?

It may be nothing. Discuss with your primary care physician. If your liver enzymes are normal, nothing more may need to be done. The interpretation however indicates the process is diffuse throughout the liver and not focal. I would repeat the sonogram in a year or two unless there are other symptoms or signs that suggest more investigation may be in order. Fatty liver is now very common—it is the no. 1 reason healthy ambulatory blood donors are rejected by blood donor centers. When “fatty liver” progresses to cirrhosis, the liver enzymes are almost always elevated. If liver enzymes are elevated, other conditions need to be rules out, such as chronic hepatitis, and if persistently elevated, a liver biopsy is done to confirm the clinical impression and stage the degree of fibrosis/cirrhosis. Because hepatitis C may progress to cirrhosis with normal enzymes levels, hepatitis C antibodies are checked in patients born between 1945 and 1965. The incidence in those “baby boomers” is reported to be 1 in 30. Don’t forget that the liver is a vital organ and any abnormal finding is significant and requires follow-up.