59-year-old female with history of HCC, HCV/alcohol cirrhosis. History of TACE and RFA. Active on the liver transplant list. Evaluate liver lesions, size and characteristics. Last scan was MRI on 3/16/2001. Evaluate vasculature. LUNG BASES: No significant abnormality noted.ABDOMEN: LIVER, BILIARY TRACT: The liver has cirrhotic morphology. Numerous arterially enhancing lesions without washout are again seen throughout the liver, which appear similar to most recent MRI from 3/16/2011. Reference lesion in the inferior right hepatic lobe measures 1.4 cm; measuring 1.7 cm on prior MRI.However, there has been overall progression in size and number of lesions since MRI from 8/25/2010. For example, the aforementioned reference lesion in the inferior right hepatic lobe measured approximately 7 mm at that time.Segment 4 RFA cavity (series 11, image 25) measures approximately 2.6 x 1.1 cm, which is relatively stable on comparison to recent MRI when accounting for differences in technique. However, there is arterial enhancement seen along the superior margin of the RFA cavity (series 9, image 23; series 80613, coronal image 68) without definite washout on delayed images. This may represent marginal tumor recurrence.Gallstones.Portal and hepatic vasculature are patent. SPLEEN: No significant abnormality noted.PANCREAS: Coarse pancreatic calcifications, likely due to chronic pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple renal cysts bilaterally without areas of abnormal enhancement.RETROPERITONEUM, LYMPH NODES: Numerous small retroperitoneal lymph nodes. Previously described enlarged gastrohepatic lymph node measures 1.5 x 2.5 cm (series 11, image 36), which is relatively stable on comparison to recent MRI when accounting for differences in technique.BOWEL, MESENTERY: Mostly fat-containing ventral hernia (series 11, image 48) with a small amount of herniation of the anterior gastric wall at this level.BONES, SOFT TISSUES: No significant abnormality noted.
1. Small focus of arterial enhancement along the superior margin of the RFA cavity without definite washout on delayed phase imaging is suspicious for marginal tumor recurrence. The RFA cavity is otherwise stable in size. Patent hepatic and portal vasculature2. Numerous arterially enhancing lesions in the liver without washout appear similar to most recent MRI from 3/16/2011. However, when compared to MRI from 8/25/2010, there has been overall progression in size and number of these lesions.