Reason: HCC screening, follow up pancreatic head cyst History: NASH cirrhosis, panc head cyst ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Loss of signal on out of phase images suggest steatosis. Subcentimeter right hepatic cysts are unchanged. Arterial enhancing lesion seen on the prior exam is no longer evident and was likely perfusional. There is a new focus of arterial enhancement (11/57) which is not seen on additional phases which may also be perfusional. Common bile duct appears normal. Vasculature is patent.SPLEEN: Mild splenomegaly, unchanged.PANCREAS: Pancreatic duct is nondilated. Cystic lesion in the pancreatic head measuring 1.1 x 1.5 cm (5/32), is unchanged and likely represents a sidebranch IPMN. Multiple adjacent cystic lesions more medially in the pancreatic head measuring overall 2.5 x 1.6 cm (5/35) with multiple small septations are also unchanged, most likely side branch IPMNs (versus dominant multiseptated lesion). Additional punctate cystic foci in the pancreatic body is also unchanged and likely represents a side branch IPMN. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left hepatic T2 hyperintensity, likely a cyst.RETROPERITONEUM, LYMPH NODES: Prominent portacaval and retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable cystic lesions in the pancreatic head, likely a side branch IPMNs; please refer to details above.2.Cirrhotic liver morphology. Arterially enhancing lesion seen on the prior exam is no longer evident and may have been perfusional in etiology.