71-year-old male with NASH cirrhosis, status post RFA for HCC and known IPMN. Please evaluate with cirrhosis protocol MR and MRCP. Exam is limited by extensive motion artifact and lack of intravenous contrast.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology is large volume abdominal ascites. A TIPS connects the right portal vein and hepatic vein. There is a wedge shaped area of T2 hyperintensity within hepatic segment 7/8 measures 6.1 x 5.0 cm (series 5, image 28) corresponding to the ablation zone as seen on prior CT, previously 7.3 x 4.6 cm. The round segment 7/8 lesion is unchanged in size 2.3 x 2.2 cm (series 1401, image 38) compared to prior 7/7/16 CT study accounting for differences in technique, it is intrinsically bright on T1 and demonstrates loss of signal on out of phase images compatible with microscopic fat content. There is characterize on CT is a slight decrease in lesion size. Post contrast images were not obtained so enhancements patterns cannot be evaluated.No biliary ductal dilatation.SPLEEN: The spleen measures 20 cm in craniocaudal dimension. Multiple collateral vessels are present in the splenic hilum.PANCREAS: Bilobed cystic lesion in the uncinate process measures 21 x 15 mm (series 7, image 14), previously measured as 2 lesions and not significantly changed in size when measured similarly.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple bilateral renal cysts are unchanged. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Enlarged periaortic lymph nodes are again seen.BOWEL, MESENTERY: Esophageal and gastric varices are redemonstrated.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Minor contrast extravasation as described in the technique section.2.Limited exam due to lack of IV contrast. Mild decrease in size of post treatment ablation zone and stable right hepatic lesion (when compared to 7/7/16 CT study). Given difficulties with breath-holding and large volume of ascites CT should be considered for future follow-up.3.Findings of splenomegaly, cirrhosis and portal hypertension.