64-year-old female with mesothelioma status post HIPEC (06/2016) ABDOMEN:LIVER, BILIARY TRACT: Slitlike T2 hyperintense focus with hypointense nodularity in the inferior right lobe of the liver is new since the prior exam. Perihepatic disease has been resected since the prior MR with residual disease studding the surface of the liver. Implant at the dome of the liver is increased in size since prior CT.Reference measurement on the lateral right lobe is provided. There is a subhepatic peritoneal mass that is slightly increased in size when compared to the prior examination.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland nodule is unchanged.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Focus of peritoneal disease along the right abdominal wall. Nodules noted in the greater curvature of the stomach and gastrosplenic ligament are similar to the prior CT. Trace perisplenic fluid.BONES, SOFT TISSUES: Rightward curvature of the lumbar spine with degenerative changes centered at L3-L4.Right paralabral cyst anterior to the to the right hip joint, increased in size. Right paralabral cyst in the gluteus minimus is unchanged in size. OTHER: No significant abnormality noted.PELVIS:UTERUS/ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Reference right lower quadrant soft tissue implant is not significantly changed in size. The posterior pelvic soft tissue implant is slightly increased to stable in size since the prior examination. Soft tissue nodularity involving anterior peritoneal reflection on prior CT not as visible on current MRI, uncertain whether reflects decreased size or differences in technique/modality.BONES, SOFT TISSUES: Rightward curvature of the lumbar spine with degenerative changes centered at L3-L4.Right paralabral cyst anterior to the to the right hip joint, increased in size. Right paralabral cyst in the gluteus minimus is unchanged in size. Heterogenous enhancement in the proximal femoral diaphysis is not evaluated well and likely unchanged.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 11/1/2016 09:18:26)VENTRAL BODY WALL COMPLEX CYSTIC LESION: 7.5 x 1.3 cm (Image 45, Series 6); 9.3 x 1.5 cm on prior (8/9/2016) (Image 94, Series 3).POSTERIOR PELVIC SOFT TISSUE IMPLANT: 3.1 x 3.7 cm (Image 60, Series 18); 3.4 x 3.0 cm on prior (8/9/2016) (Image 127, Series 3).RIGHT LOWER QUADRANT SOFT TISSUE IMPLANT: 4.3 x 4.3 cm (Image 63, Series 18); 4.1 x 3.4 cm on prior (8/9/2016) (Image 127, Series 3).RIGHT SUBHEPATIC NODULE: 2.2 x 2.8 cm (Image 234, Series 10).
Peritoneal/mesenteric and subcapsular metastatic foci as detailed above are stable to slightly increased in size when compared to the prior examinations. There are no definite new lesions identified, accounting for differences in technique and modality (comparison made to prior postoperative CT). Findings and images reviewed with Dr. Turaga.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.