Reason: portal vein clot reassessment History: portal vein thrombosis The arterial phase is somewhat late which mildly limits evaluation, though this does not significantly impact evaluation of the clinical question.ABDOMEN:LIVER, BILIARY TRACT: The liver has normal morphology. There is a subcentimeter T2 hyperintense lesion within hepatic segment 5/8 which is too small to characterize with reference measurements below.There is a wedge-shaped area of increased T2 signal within hepatic segment 8 with a smaller similar area in the far lateral aspect of segment 2/3. These areas demonstrate corresponding increased enhancement on early phase postcontrast images without associated washout. There is a linear T1 hypointense branching structure in segment 8 which extends to the periphery which is thought to represent a thrombosed subsegmental branch of the right anterior portal vein. There is an additional similar structure extending peripherally into segment 2/3 which is also thought to represent a thrombosed subsegmental branch of the left portal vein.The more proximal branches of the portal vein and superior mesenteric vein appear patent. The hepatic veins appear patent. The hepatic artery appears patent.No biliary ductal dilatation.SPLEEN: Status post splenectomy.PANCREAS: Status post distal pancreatectomy. The remaining pancreatic parenchyma demonstrates normal parenchymal signal intensity and enhancement. The proximal pancreatic duct is nondilated. No discrete pancreatic lesions are identified, however, this examination was not specifically tailored for evaluation of the pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes to anterior abdominal wall.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 9/22/2016 14:00:00)HEPATIC SEGMENT 5/8 LESION: 0.4 x 0.5 cm (Image 23, Series 501).
1.Thrombosed subsegmental branches of the portal vein in hepatic segments 8 and 2/3 with associated perfusional changes. No evidence of thrombus within the more proximal branches of the main portal vein or superior mesenteric vein.2.Postsurgical changes related to splenectomy and distal pancreatectomy. No discrete pancreatic lesions are identified, however, this study was not specifically tailored for evaluation of the pancreas.3.Subcentimeter hepatic segment 5/8 T2 hyperintense lesion too small to characterize.