59-year-old man with history of HCC, scheduled to undergo TheraSphere treatment Please note that this examination is limited as patient refused intravenous contrast and the images are degraded by respiratory motion.ABDOMEN:LIVER, BILIARY TRACT: There is a 20.6 x 16.6 cm heterogeneous, encapsulated lesion in the right lobe of the liver. Areas of increased T1 signal within this lesion suggest hemorrhage. The right portal vein is not visualized and likely occluded. The right hepatic vein is also not visualized and likely occluded. The middle hepatic vein is markedly attenuated by adjacent mass effect. There is moderate biliary duct dilatation of the left hepatic duct and its branches.No additional focal hepatic lesions are identified. The gallbladder appears normal.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple cysts are seen in the kidneys bilaterally with increased T1 signal suggesting hemorrhage but no significant soft tissue component or septations.RETROPERITONEUM, LYMPH NODES: A periportal lymph node (series 11, image 41) measures 29 x 16 mm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Numerous lung base nodules are seen bilaterally. Patient is status post sternotomy with susceptibility artifact noted.
1.Large, solitary right hepatic mass with adjacent mass effect/occlusion on the portal and hepatic veins as described.2.Enlarged periportal adenopathy.3.Partially visualized lung base nodules suspicious for metastases.