Liver lesion. ABDOMEN:LIVER, BILIARY TRACT: At least 4 lesions are demonstrated in the liver. A large left hepatic lobe mildly T2 hyperintense lesion measures approximately 7.7 x 6.9 cm (series 4, image 27). There is suggestion of central scar demonstrating T1 hypointense signal (series 10, image 59) and mild contrast retention on delayed phase images (series 15, image 60). Two more very slightly hyperintense T2 lesions are better seen on diffusion weighted images. The second ill-defined segment 4 lesion abutting the gallbladder measures approximately 2.7 x 1.9 cm (series 100, image 13). Another small medial right hepatic lobe segment 8 lesion is noted (series 100, images 17). A fourth lesion in segment 8 is best seen on early arterial postcontrast sequence (series 11, image 58). All demonstrate arterial enhancement and are relatively isointense on portal venous phase.SPLEEN: No significant abnormality noted.PANCREAS: No focal pancreatic lesion.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: Kidneys enhance symmetrically without focal lesion.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Bowel is normal in caliber without evidence of obstruction or ileus. No abnormal enhancement.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
At least 4 hepatic lesions are demonstrated in both lobes of the liver, with largest in the left hepatic lobe with suggestion of central scar. These lesions most likely represent focal nodular hyperplasia, though multiple hepatic adenomas are also differential considerations. Repeat imaging with hepatocellular specific contrast agent would be helpful in differentiating these lesions.