74-year-old male patient with cirrhosis. Screening examination for HCC. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. Interstitial T2 hyperintensity is compatible with hepatic fibrosis. There is an arterially enhancing lesion in the inferior aspect of the right hepatic lobe measuring 1.6 x 1.6 cm (image 71, series 10), previously 1.6 x 1.5 cm. There is no definite washout of this lesion, which bulges the capsule. There is an arterially enhancing lesion within the right hepatic dome which has increased in size measuring 1.5 x 1.2 cm, previously 0.9 x 0.7 cm (image 30, series 10). There is washout of this lesion on delayed imaging. A segment 8 focus of arterial enhancement without definite washout appears smaller in size (image 45, series 10). There is no intra- or extrahepatic biliary ductal dilatation. The hepatic vasculature is patent.Trace perihepatic ascites, slightly increased from the prior study. Recannulated periumbilical vein. SPLEEN: Wedge-shaped signal abnormality in the dorsal aspect of the spleen may reflect a small chronic infarct.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Several bilateral T2-weighted hyperintense foci some of which are too small to characterize, likely simple cysts. Mild right renal cortical scarring/thinning.RETROPERITONEUM, LYMPH NODES: Aneurysmal dilatation of the proximal abdominal aorta measuring up to 3.3 cm in diameter.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral gynecomastia. Compression deformity of a midthoracic vertebral body is incompletely evaluated and only seen on the coronal images.OTHER: Extensive susceptibility artifact is noted in the mid-abdomen.
1.Enlarging right hepatic dome lesion with imaging characteristics compatible with hepatocellular carcinoma.2.Additional arterial enhancing foci without washout are again noted; attention to these lesions on follow up imaging is recommended.