63-year-old male with HCC, HCV, status post TACE/RFA 2 lesions. Evaluate liver lesions, masses, HCC screening, vessel patency, coronary calcification. ABDOMEN:LIVER, BILIARY TRACT: Again noted cirrhotic liver and an ablated lesion in the segment 7 measuring 3.3 x 2.4 cm image #271, series #10. No evidence of enhancement of this lesion. A more superiorly located hepatic cyst is also unchanged.There are 2 new arterially enhancing and then washing out lesions in the right lobe of the liver consistent with hepatocellular carcinoma. One of these lesions measures 2.1 x 1.7 cm on image #56, series #10. The second lesion measures 1.6 x 1.7 cm on image #59, series #10. Another subcentimeter arterial enhancing lesion near the gallbladder on image #47, series #10 does not demonstrate definite washout, however, demonstrates restricted diffusion and also suspicious for hepatocellular carcinoma. Another similar lesion is best seen on image #72, series #10, in the left lobe of the liver.SPLEEN: Mild splenomegaly, unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Post ablation changes in the right lobe of the liver. New at least 2 arterially enhancing and washing out on delayed phase images consistent with hepatocellular carcinoma. There are a few other enhancing lesions at the arterial phase with restricted diffusion, also suspicious for hepatocellular carcinoma even though they don't meet the criteria for HCC.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.