64 years, Male, Reason: 64 y/o M with PMH of ADHF presents with concern for liver lesion on previous imaging, please evaluate History: as above. ABDOMEN:LUNG BASES: Small bilateral pleural effusions. LIVER, BILIARY TRACT: Diffuse reticular pattern with dilated hepatic veins, likely representing passive hepatic congestion. Hepatomegaly.There is a lesion in segment 6/7 measuring 1.4 cm (501/22) with a focus of enhancement which persists on delayed phase images. There is an additional adjacent lesion which is mildly hyperintense on T2 with minimal irregular enhancement and delayed phases (1001/22). A few smaller faint T2 hyperintense lesions are also present.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Increased T2 signal and enlargement of the left psoas muscle.OTHER: Moderate ascites.
1.There are two right hepatic lobe lesions enhancing lesions. These do not meet criteria for hemangioma and have a non specific appearance. Differential considerations include metastatic disease, regenerative nodules in the setting of hepatic venous congestion. The stability in their size suggests against metastasis. If needed a biopsy of these lesions can be performed.2.Diffuse reticular pattern within the liver suggests passive congestion.3.Moderate ascites.4.Increased T2 signal and enlargement of left psoas muscle.