History of hepatitis and hepatocellular carcinoma status post TACE/RFA. Prior MRI dated 4/16/2015 demonstrated nodular arterial enhancement adjacent to an ablation cavity. The patient subsequently underwent TACE/RFA of this region. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology.New right hepatic lobe peripheral ablation cavity between the previously described anterosuperior and posterosuperior ablation cavities resulting in a large more confluent cavity now measuring 7.4 x 2.8 cm. Right hepatic lobe inferior ablation cavity measures 1.5 x 1.7 cm compared to 1.8 x 2.1 cm previously.Mild adjacent heterogeneous signal but no suspicious T2 weighted signal abnormality, postcontrast enhancement, restricted diffusion or washout adjacent to these ablation cavities or in the remainder of the liver.Note is made of a stable arterial enhancing focus abutting the posterior division of the right portal vein and possibly communicating with a right hepatic vein (series 9 image 118) which follows blood pool signal intensity and likely reflects a small portal venous fistula.Cirrhotic liver morphology. Findings of portal hypertension including extensive gastroesophageal varices, perisplenic varices and splenomegaly.The hepatic artery, portal vein and hepatic veins are patent. No biliary ductal dilatation.Cholelithiasis within a normally distended gallbladder. There is unchanged extensive gallbladder wall thickening which is likely reactive in the setting of cirrhosis.SPLEEN: Splenomegaly measuring 17.3 cm in length with perisplenic collateral vessels.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: Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Post ablation changes in the right hepatic lobe without specific evidence of residual HCC. The previously seen nodular enhancing lesions are no longer evident.2.Cirrhotic liver morphology with portal hypertension. No new suspicious liver lesion.