History of cirrhosis and nonspecific lesion on prior MRI. ABDOMEN:LIVER, BILIARY TRACT: The liver is shrunken and nodular in morphology. There are small esophageal and perigastric varices. Small volume of perihepatic ascites. Borderline enlarged spleen. These findings are consistent with cirrhosis.A TIPS is in place. The portal vein proximal to the TIPS catheter is patent. The hepatic artery is patent as well as the middle and left hepatic veins. The right hepatic vein is not visualized due to artifact from the TIPS.Stable 9 x 9 mm lesion (series 9/17) in the right hepatic dome is difficult to see on T2-weighted imaging, appears mildly hyperintense on T1-weighted images. There is questionable faint arterial enhancement without restricted diffusion, no definite washout on subsequent delayed imaging.Stable peripheral wedge-shaped arterially enhancing focus extending from the distal end of the TIPS to the hepatic dome with persistent enhancement on delayed sequences with mild T2-weighted signal hyperintensity, likely a perfusion abnormality.SPLEEN: Mildly prominent spleen measuring 11 cm. Stable 1.8 cm distal splenic artery aneurysm (series 5/13).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: Small broad-based umbilical hernia containing small bowel without evidence of complication.Small loculated pocket of fluid at the GE junction is unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable size and nonspecific appearance of the right hepatic dome lesion not meeting strict criteria for HCC. No new suspicious lesion.2.Cirrhosis, portal hypertension and TIPS placement.3.Stable 1.8 cm distal splenic artery aneurysm.