History of hepatocellular carcinoma status post repeat TACE/RFA. ABDOMEN:LIVER, BILIARY TRACT: The liver is cirrhotic in morphology. Patent hepatic vasculature.Anterior right hepatic lobe ablation cavity (see 9, image 38) measures 3.6 x 3.7 cm, previously 3.6 x 3.7 cm. The ablation cavity demonstrates intrinsic high T1 signal without enhancement, compatible with intracavitary blood products and/or proteinaceous material.At the location of the previously described 2 adjacent suspicious arterially enhancing lesions within segment 7/8, there is a new ablation cavity from intervening ablation (series 9, image 18) measuring 2.4 x 3.5 cm. Ablation cavity demonstrates intrinsic high T1 signal without internal enhancement, compatible with intracavitary blood products and/or proteinaceous material. The ablation cavity demonstrates equivocal thin rim enhancement (e.g., anteriorly on image 14 series 8/image 13 series 101) which may be treatment related, no corresponding washout seen on subsequent more delayed imaging.No new suspicious arterially enhancing lesions are identified.Status post cholecystectomy. No biliary ductal dilatation.SPLEEN: Mild splenomegaly with spleen measuring up to 14.7 cm in length. Large splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Slight left adrenal nodularity is similar to prior.KIDNEYS, URETERS: Subcentimeter renal cysts not significantly changed.RETROPERITONEUM, LYMPH NODES: Stable mildly enlarged portacaval and gastrohepatic lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Focal fat-containing T2 hyperintense lesion in the left L2 vertebral body which has been previously biopsied and may represent a hemangioma, not significantly changed.OTHER: No significant abnormality noted.
Interval ablation of 2 adjacent suspected HCC lesions in the right hepatic lobe without evidence of residual or recurrent hepatocellular carcinoma. The ablation cavity demonstrates equivocal thin rim enhancement which may be treatment related, no corresponding washout seen on subsequent more delayed imaging. Continued follow-up is recommended.