History of hepatitis C cirrhosis. Prior nonspecific lesions on CT. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. The liver measures 17.6 cm in craniocaudal dimension. Trace perihepatic ascites.Best seen on the T2-weighted images is a 2.8 x 2.5 cm lesion adjacent to the gallbladder fundus (series 4/69) demonstrating very mild heterogeneous T2 weighted hyperintensity (series 3/30) and subtle arterial enhancement (series 9/29 and corresponding subtraction images). The lesion is mildly heterogeneous. No definite relative washout of the lesion.No additional suspicious lesion.The examination is at least partial portal vein thrombosis. The hepatic artery and hepatic veins are patent.Right hepatic lobe segment 6 subcentimeter cyst.No intrahepatic or extrahepatic biliary ductal dilatation.Normally distended gallbladder.SPLEEN: The spleen measures 9.3 cm in length without a focal lesion. Perisplenic collaterals. Abdominal wall collateral vessels.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuation of a segment of the right renal inferior pole compatible with an infarct.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small incisional fat and fluid containing hernias. Right lateral lower abdominal wall lipoma measuring 6.3 x 4.7 cm.Mild infrarenal abdominal aortic ectasia and atherosclerotic disease. OTHER: No significant abnormality noted.
2.8 cm lesion adjacent to the gallbladder fossa demonstrates subtle heterogeneous arterial enhancement, restricted diffusion and T2-weighted hyperintensity; no definite washout. Although lesion does not meet strict imaging criteria for an HCC, findings remain suspicious, continued follow-up and/or tissue sampling recommended.Cirrhosis, small volume perihepatic ascites and collateral vessel formation. At least partial portal vein thrombosis. Demonstrated again is a right renal segmental infarct.