Cirrhotic liver with mass. ABDOMEN: Left gastric embolization coils resulting in susceptibility artifact obscuring much of the left hemi-abdomen.LIVER, BILIARY TRACT: Mildly nodular liver contour.The faint lesion in segment IV (series 1 201/298) is not significantly changed in size measuring 2.2 x 1.5 cm. The lesion has some signal dropout on out of phase imaging indicating steatosis.Vessels appear to traverse the lesion without distortion. No significant arterial enhancement. Mild hypointensity on portal venous and delayed phases is unchanged. No discrete capsule is evident.Subcentimeter right hepatic lobe simple cyst. Transjugular intrahepatic portosystemic shunt is present and appears patent on post-contrast imaging. The portal vein is patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: The left adrenal gland is not visualized. The right adrenal gland is normal.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Gynecomastia. OTHER: No significant abnormality noted.
Stable non-specific segment 4 lesion. Somewhat geographic appearance, steatosis and non-distorted traversing vessels raises the possibility of focal fat deposition. However, given the patient's history of cirrhosis and subtle drop-out on delayed imaging continued follow-up is recommended. Eovist with hepatobiliary phase imaging or hepatobiliary phase imaging using Multihance should be considered (requested on the order) to assess for hepatocellular function which may help differentiate the lesion.