64-year-old female with history of cirrhosis who presents for HCC screening and monitoring of IPMN. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. In the medial left hepatic lobe, there is arterial enhancement without definite washout peripheral to T1 and T2 hypointense, nonenhancing tubular focus. The portal and hepatic veins are patent.T2 hyperintense foci in segment 5 and 7 without contrast enhancement, most compatible with cysts.Cholelithiasis with mild gallbladder wall thickening, which may be secondary to chronic liver disease.SPLEEN: No significant abnormality noted.PANCREAS: Normal T1 intrinsic hyperintensity of the pancreatic parenchyma. Pancreatic duct is normal in caliber. Uncinate process branch type IPMN is not significantly changed, currently measuring 9 x 8 mm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is evidence of mesenteric edema/small volume ascites.BONES, SOFT TISSUES: Thoracic dextroscoliosis and lumbar levoscoliosis.OTHER: No significant abnormality noted.
1.In the medial left hepatic lobe, there is arterial enhancement without definite washout peripheral to a T1 and T2 hypointense, nonenhancing tubular focus. Findings may represent a thrombosed vessel with associated perfusion defect versus a central occult lesion with focal biliary dilatation. Short-term follow-up in approximately 3 months is recommended.2. Cholelithiasis and gallbladder wall thickening, which is likely secondary to chronic liver disease. 3. Stable pancreatic IPMN.