43-year-old male with congenital hepatic fibrosis. Recent ultrasound completed at OSH indicated to large hepatic masses. Evaluate for HCC. ABDOMEN:LIVER, BILIARY TRACT: Multifocal lesions in both hepatic lobes that demonstrate increased T1 signal intensity (axial series 13 images 38, 54, 58, 74, 98, 114, 134, 154, 164), decreased T2 signal intensity, and contrast enhancement. No washout or arterial hyperenhancement is identified. The largest lesion in the left hepatic lobe measures 8.7 x 7.7 cm. These lesions are favored to represent regenerative nodules and are stable in appearance since the 2008 MRI exam.Cystic dilatation of intrahepatic bile ducts, which are massively dilated at the hepatic dome. No extrahepatic biliary ductal dilatation.There is cavernous transformation of the portal vein and large gastric and splenic varices. A splenorenal shunt is noted, and there is dilatation of the left renal vein. Mild dilatation of the common hepatic duct is also noted.SPLEEN: Splenomegaly measuring 20 cm in craniocaudal length.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multifocal small bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Bilobar hepatic lesions with T1 hyperintensity, T2 hypointensity, and contrast enhancement are compatible with regenerative nodules. These lesions are unchanged in appearance since the 2008 MRI exam. No evidence for malignancy.2.Extensive cystic dilatation of the intrahepatic bile ducts, which are markedly dilated at the hepatic dome. Also unchanged.3.Stigmata of portal hypertension including splenomegaly, gastric/splenic varices, and a splenorenal shunt.