History of HCC treated with radiofrequency ablation x 2. Study is slightly limited by patient's body habitus and inability to place arms above the head.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology with findings of segment V/VIII focal confluent fibrosis. Stigmata of portal hypertension including splenomegaly, gastroesophageal varices and recannulized periumbilical vein.The liver parenchyma demonstrates loss of signal on in phase imaging compatible with iron deposition.In segment 3, inferior lateral segment of the left hepatic lobe there is a 2.7 x 1.7 cm postablation halo (series 9/41) which is intrinsically T1 hyperintense. No residual arterial enhancing lesion is evident.Several scattered arterial enhancing foci become isointense on the delayed imaging likely representing perfusional anomalies.No new suspicious arterially enhancing lesion demonstrating washout.Segment 7 and segment 8 simple cyst.The hepatic vessels appear patent. Portal vein enlargement compatible portal hypertension.Cholelithiasis within a normally distended gallbladder. No biliary ductal dilatation.SPLEEN: Marked splenomegaly with the spleen measuring 22 cm in craniocaudal dimension. Splenic hilar collateral vessels. PANCREAS: Multiple T2 hyperintense lesions within the pancreas most of which appear to communicate with the main pancreatic duct and likely represent side branch IPMNs. The main pancreatic duct is normal in caliber. The largest lesion is in the pancreatic body/tail measuring 1.6 x 1.1 cm (series 5/17), not significantly increased in size. No suspicious enhancing imaging features. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small right renal exophytic simple cyst. No hydronephrosisRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small right pleural effusion with compressive atelectasis. Rate recanalized periumbilical vein.
Interval re-ablation of the segment 3 hepatic lesion without evidence of residual or recurrent disease. No new suspicious lesion. Cirrhosis with portal hypertension. Small right pleural effusion.