57-year-old male with HCV cirrhosis. Evaluate for hepatocellular carcinoma. Due to contrast injector malfunction, no precontrast images were obtained. Initially 15 mL of MultiHance was administered obtaining a portal venous phase. After approximately 20 minutes, an additional 12 mL was injected obtaining the arterial, portal venous, and delayed phases.ABDOMEN: LIVER, BILIARY TRACT: Severely cirrhotic hepatic morphology with caudate hypertrophy. There is been progression of confluent fibrosis and retraction. There are no arterially enhancing lesions. The delayed images demonstrate heterogeneous appearance of the hepatic parenchyma consistent with delayed enhancement within the fibrous bands rather than washout. Cholelithiasis.Gastroesophageal varices are noted.SPLEEN: Splenomegaly is noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large volume ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Sequela of severe cirrhosis without evidence of arterially enhancing lesions. The delayed images demonstrate heterogeneous appearance consistent with delayed enhancement within the confluent fibrosis rather than washout.