Reason: HCC screening History: Hepatitis C cirrhosis. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Trace perihepatic ascites.There is redemonstration of a lesion within hepatic segment 7 which has not significantly change in size with reference measurements below. The lesion demonstrates increased T2 signal (more pronounced than prior), restricted diffusion, and arterial enhancement without definite washout.There is an additional arterially enhancing lesion more posteriorly within hepatic segment 7 with reference measurements below which demonstrates washout on more delayed images.The hepatic vasculature appears patent. Upper abdominal collateral vessels.Cholelithiasis. No significant biliary ductal dilatation.SPLEEN: The spleen is enlarged and measures up to 20 cm in the craniocaudal dimension. T2 hyperintense lesion within the anterior aspect of the spleen most consistent with hemangioma, not significantly changed.PANCREAS: No significant abnormality noted. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Susceptibility artifact related to IVC filter.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 9/16/2016 14:00:00)HEPATIC SEGMENT 7 ANTERIOR LESION: 1.3 x 1.0 cm (Image 154, Series 10); 1.3 x 1.0 cm on prior (7/28/2015) (Image 15, Series 10).HEPATIC SEGMENT 7 POSTERIOR LESION: 0.7 x 0.6 cm (Image 170, Series 10); 0.7 x 0.6 cm on prior (7/28/2015) (Image 27, Series 10).
1.Hepatic segment 7 arterially enhancing lesion which lacks washout but demonstrates newly increased T2 signal and restricted diffusion and is suspicious but not definitive for early HCC. 2.Additional hepatic segment 7 arterially enhancing 7 mm lesion which newly demonstrates washout and which is suspicious for HCC.3.Cirrhotic liver with sequelae of portal hypertension.