Alcoholic cirrhosis status post TACE RFA. Evaluate for HCC. History of biopsy-proven well-differentiated hepatocellular carcinoma 3/31/2016. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic fibronodular liver morphology. Segment 6/7 ablation cavity measures approximately 5.6 x 2.5 cm with intrinsic T1 weighted signal hyperintensity. No evidence of marginal recurrent or residual disease.Segment 3 1.0 x 0.9 cm lesion (series 1 101/167) which demonstrates mild arterial enhancement but no definite washout. It is associated with mild T2-weighted hyperintensity. The lesion is slightly more discrete when compared to the prior study.Several punctate intrinsically T1 weighted hyperintense foci are unchanged.No additional suspicious arterially enhancing lesion or lesion demonstrating washout on delayed phase imaging. On delayed phase imaging there are several punctate circumscribed hypointense foci which become more conspicuous which is likely related to the background fibrosis.No intra or extrahepatic biliary ductal dilatation.Cholelithiasis within a normally distended gallbladder. No evidence of gallbladder inflammation.Hepatic vasculature appears patent.Trace perihepatic ascites. Recannulation of the periumbilical vein.SPLEEN: Normal splenic size with numerous Gamna-Gandy bodies. Trace perisplenic fluid.PANCREAS: No pancreatic ductal dilatation. No focal lesion.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: New vague T2-weighted signal hyperintensity of a mid thoracic vertebral body only seen on the coronal images, correlate with the recent nuclear medicine bone scan.Heterogeneous subcutaneous fat and periumbilical region compatible with recent hernia repair.OTHER: No significant abnormality noted.
1.Post ablation changes of segment 6/7 without evidence of marginal recurrent or residual disease.2.Arterially enhancing 1.0 cm segment 3 lesion without washout does not meet strict imaging criteria for HCC. Continued short interval follow-up is recommended.3.Cirrhotic fibronodular liver morphology with trace ascites and recannulated periumbilical vein.