Reason: HCC screening History: NASH and alpha-1 antitrypsin cirrhosis, hemosiderosis. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. There are innumerable, diffusely distributed subcentimeter foci of decreased signal within the liver more prominent on out of phase images compatible with siderotic nodules. There are several subcentimeter arterially enhancing foci for example within the left hepatic lobe (series 1101, image 602) and right hepatic lobe (series 1101, images 497, 542, and 562) which lack definite associated washout.Replaced hepatic artery arising from the superior mesenteric artery which provides arterial flow to both the right and left lobes of the liver. Hepatic veins and portal vein appear patent.The gallbladder is normal in morphology. No biliary ductal dilatation is identified.There is evidence of portal hypertension including extensive portosystemic collaterals and a patent periumbilical vein.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas demonstrates mildly decreased T1 signal. No focal pancreatic lesions are identified. The pancreatic duct is nondilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Nodular, cirrhotic liver with evidence of portal hypertension.2.Several subcentimeter foci of hepatic arterial enhancement which are too small to accurately characterize but without definite washout to suggest hepatocellular carcinoma.