Evaluate lesion seen on recent CT imaging, Budd-Chiari and regenerative nodules, status post TIPS ABDOMEN:LIVER, BILIARY TRACT: A significant portion of the liver primarily the right lobe is not able to be evaluated due to extensive susceptibility and blooming artifact from intrahepatic vascular stent placement. Multiple arterially enhancing bilobar hepatic lesions seen with washout suggested (refer to key images and see images 26 and 58 series 103), suspicious for multifocal hepatocellular carcinoma. Submitted for reference is hepatic segment 2 lesion measuring 1.2 x 1.1 cm on image 25 series 11, and a right hepatic lesion measuring 1.1 x 1 cm on image 58 series 11. Unable to definitively identify corresponding restricted diffusion. Accounting for differences in technique and modality, lesions are probably unchanged in size from prior exam. Heterogeneous liver parenchymal signal particularly in postcontrast venous phase.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.
Evaluation of multiple arterially enhancing liver lesions was better achieved on prior CT imaging as much of the liver parenchyma is unable to be evaluated on the current MRI exam secondary to extensive susceptibility and blooming artifact from vascular stent placement. Bilobar arterially enhancing lesions seen with washout suggested on subsequent more delayed phase imaging, suspicious for multifocal HCC, see discussion above.