Reason: evaluation of exatension of liver mass History: known HCC ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. The ablation cavity has decreased in size since the prior MRI. There is increased tumor superior to the ablation cavity, within segments 5 and 8. A reference segment 5 lesion measures 3.3 x 2.2 cm, similar to the recent CT but increased since the prior MR where it measured 2.1 x 1.1 cm. This lesion extends into the anterior branch of the right portal vein as well as multiple smaller branches which are dilated. This extends peripherally within segment 8 and a geographic distribution with increased T2 signal, enhancement and restriction on diffusion-weighted images. The main portal vein is patent. Nonspecific gallbladder wall thickening is again noted.SPLEEN: No significant abnormality noted.PANCREAS: Cystic lesion in the pancreatic head measures 1.9 x 1.2 cm (601/16), previously 1.7 x 1.1 cm and likely communicates with the main pancreatic duct. This lesion is has a complex appearance with internal septations.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild edema in the right chest wall and subcutaneous tissues. Moderate degenerative changes of the spine. Scoliosis.OTHER: 6 mm left lower lobe lung nodule is better evaluated on recent CT.
1.Status post hepatic ablation with tumor superior to the ablation cavity, increased from the prior MRI but similar to recent CT.2.Tumor thrombus within the anterior branch of the right portal vein.3.Cystic lesion within the pancreatic head likely represents a complex sidebranch IPMN.