History of HCC, evaluate for interval change after TACE/RFA. ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates fissural widening and a nodular contour compatible with cirrhosis. Multiple subcentimeter T2 hyperintense lesions in the liver are too small to characterize and likely represent cysts. There is once again trace perihepatic ascites.On the prior examination, there was a segment 4 ablation cavity with high T1 signal intensity with a rim of enhancement immediately posterior to the area of high T1 signal intensity. On today's examination, the area of high T1 signal within segment 4 has increased in size now measuring 3.3 x 4.0 cm (series 10, image 24) corresponding to interval ablation cavity and which encompasses the previously described area of rim enhanced. Postcontrast images demonstrate mild rim enhancement surrounding the ablation cavity without washout which likely represents posttreatment change. There is a new area of abnormal signal along the posterior margin of the left hepatic lobe in continuity with the ablation cavity which demonstrates intermediate T1 and T2 signal as well as peripheral enhancement measuring approximately 2.6 x 7.5 cm (series 11, image 26) and which most likely represents a postprocedural hematoma.There is an arterially enhancing lesion along the anterior aspect of the left hepatic lobe (series 11, image 40) measuring 9 x 9 mm. This lesion demonstrates isointense signal on T1 and T2-weighted images and becomes centrally hypointense on delayed postcontrast images. Attention should be paid to this lesion on subsequent imaging. Additional scattered foci of arterial enhancement without washout are noted in the peripheral liver parenchyma, compatible with perfusional anomalies. The hepatic vasculature appears patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right upper pole small wedge-shaped T2 hyperintensity.RETROPERITONEUM, LYMPH NODES: Prominent periportal lymph node (series 11, image 136) has increased in size from prior and is nonspecific.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Cirrhotic liver morphology.2.Interval ablation of suspected marginal recurrence along the posterior lateral aspect of segment 4 ablation cavity without evidence of recurrence.3.2.6 x 7.5 cm area of abnormal signal along the posterior aspect of the left lobe of the liver in continuity with the ablation cavity and which most likely represents a postprocedural hematoma.4. 9 mm arterial enhancing lesion within anterior left hepatic lobe which is indeterminant but should be monitored on subsequent examinations.