66-year-old male with metastatic thyroid cancer to the liver. Compared to previous with measurements. ABDOMEN:LIVER, BILIARY TRACT: Normal morphology of the liver.In hepatic segment 8, the T2 hyperintense lesion measuring 1.1 x 1 cm (axial series 7 image 11) again demonstrates discontiguous nodular enhancement compatible with a benign hemangioma (prior 1.1 x 1.1 cm).In the hepatic dome/superior-lateral caudate lobe, the faintly T2 hyperintense, strongly T1 hyperintense lesion measuring 2.6 x 1.7 cm (axial series 9 image 20) (prior 2.1 x 1.8 cm) shows no definite intralesional enhancement on the postcontrast subtraction series (axial series 100 image 18). Mild restricted diffusion is noted on DWI series and remains suspicious for metastatic disease. In hepatic segment 6, the faintly T2 hyperintense T1 hypointense lesion is increased in size currently measuring 2.1 x 1.5 cm (axial series 9 image 43). The prior measurement was approximately 1.5 x 1 cm. The lesion demonstrates enhancement and washout.The gallbladder is partially distended with T1 hyperintense fluid, which could represent biliary sludge versus vicarious excretion of intravenous contrast from the same day CT head and chest exams with intravenous contrast.The T2 hyperintense foci scattered throughout the liver are again noted and too small to characterize, favor cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Trace upper abdominal ascites.BONES, SOFT TISSUES: Similar-appearing hyperintense focus of the T10 vertebral body again suggestive of a benign osseous hemangioma.The previously described curvilinear T2 hypointense signal of the bilateral femoral heads and the previously described T2 hyperintense lesion of the posterior left iliac wing are not well visualized.OTHER: Suspected nodules in the lung bases.
1.Enhancing lesion with washout in hepatic segment 6 has increased in size and again consistent with metastatic disease.2.The T1 hyperintense lesion in hepatic segment 1/caudate is stable in size, and no intralesional enhancement is appreciated on the postcontrast subtraction sequence. The intralesional restricted diffusion is again worrisome for a metastatic focus.3.Stable appearance of the segment 8 suspected hepatic hemangioma.4.Suspected nodules in the lung bases. Please refer to same day CT chest exam for further details.