HCC, cirrhosis. Assess response to TACE/RFA. ABDOMEN:LIVER, BILIARY TRACT: The more recent ablation cavity in the right inferior hepatic lobe measures approximately 2.8 x 2.1 cm (series 12, image 65) and appears similar to that seen on the prior study. The initial ablation cavity is redemonstrated in the right lobe and unchanged, measuring approximately 2.1 x 1.1 cm (series 12, image 52).Peripheral and superior to the initial ablation cavity in segment 5, there is a new ill-defined area of abnormally increased T2 and DWI signal, the largest component of which measures approximately 2.3 x 1.7 cm (series 3, image 19). This lesion is incompletely evaluated, as the postcontrast arterial phase images are suboptimally timed, however suggestion of hypointense signal on delayed phase images is suspicious for hepatocellular carcinoma. There is an adjacent associated branching hypoenhancing tubular structure (best seen on 3 minute delay sequences, series 13, image 57), which may represent expanded and invaded portal vein branches.Gallbladder sludge layers dependently. Gallbladder is hydropic morphology, which may related to fasting state, as there is no pericholecystic fluid or gallbladder wall thickening to suggest acute cholecystitis.SPLEEN: No significant abnormality noted.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable ablation cavities.2.New segment 5 hyperintense T2/DWI ill-defined lesion, suboptimally evaluated due to timing of arterial phase postcontrast images. Imaging characteristics are suspicious for hepatocellular carcinoma and possible portal vein branch invasion.3.The patient will be called back for repeat arterial phase sequence.