History of hepatitis B and hepatocellular carcinoma status post TACE RFA most recently on 8/13/2015 ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology including hypertrophy of the left hepatic and caudate lobes. Status post cholecystectomy. The common bile duct measures up to 13 mm, however tapers smoothly to the level of the ampulla, unchanged. No filling defect suggesting mass or gallstone. Cystic duct remnant is noted.More centrally in the posterior segment is a new ablation cavity measuring 2.5 x 1.8 cm (series 9/235). No residual enhancing lesion. No new arterial enhancing lesion.Right hepatic lobe inferior ablation cavity measures 3.4 x 1.9 cm (series 9/235), compared to 3.3 x 1.9 cm previously.The slightly more superior right hepatic lobe peripheral ablation cavity measures 2.6 x 1.8 cm (series 9/232), unchanged.The left hepatic lobe ablation cavity measures 1.9 x 1.4 cm (series 9/235), unchanged.Stable hypervascular lesion in the left lateral segment of the liver, characterized as a portal to hepatic venous shunt.The portal vein is patent. The visualized hepatic artery is patent.No specific stigmata of portal hypertension.SPLEEN: The spleen is normal in size without a focal lesion.PANCREAS: The pancreas is normal in morphology. The main pancreatic duct is normal in caliber. There is a stable 4 mm pancreatic head side branch IPMN. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate renal cysts are noted bilaterally. No hydronephrosis or suspicious renal lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Nonspecific mild elevation of the left hemidiaphragm. Trace pleural fluid.
Post ablation changes of the posterior segment hepatic lesion without residual arterially enhancing component. No new suspicious liver lesion. Otherwise stable ablation cavities in both the right and left hepatic lobe.