Reevaluate extent of disease in patient with HCC. Ascites, abdominal pain. ABDOMEN: Limited study due to significant dielectric effect due to ascites.LIVER, BILIARY TRACT: Post changes of right partial hepatectomy. Cirrhotic morphology of the remaining liver.Bilobar numerous arterial enhancing masses with washout consistent with multifocal HCC, significantly increased in size from prior.Reference segment 4 lesion is 3.7 x 3.4 cm (series 1601, image 227), previously 2.7 x 2.6 cm. Additional nonreference lesion are also larger.Postsurgical findings of cholecystectomy. Intrahepatic right portal vein is blunted at its distal end and the left portal vein is not visualized, unchanged. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Edematous wall thickening of the right colon and diffuse small bowel wall thickening, likely related to portal hypertension.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large amount of ascites.
Significant interval progression of bilobar multifocal HCC. Limited study due to dielectric effect from large amount of ascites; for follow-up exams, consider doing a paracentesis prior to MRI for improved diagnostic quality.