Female 81 years old Reason: 81 F with HCC, please eval for evidence of disease recurrence. No contrast due to low GFR. History: none ABDOMEN:LIVER, BILIARY TRACT: Segment 4 ablation cavity measures 3.6 x 3.0 cm and is mostly T2 hypointense. There is new surrounding nodular T2 hyperintensity and areas of restricted diffusion involving segments 4 extending to segment 8 which is suspicious for tumor. There is signal abnormality measures approximately 13 x 6 cm. Vessel patency of the left portal vein cannot be verified without contrast. There is some signal abnormality on the T2-weighted imaging which may be a sequelae of tumor vs. flow artifact due to portal hypertensionGallbladder contains multiple gallstones. Percutaneous cholecystostomy tube is present. Common bile duct is normal in caliber.SPLEEN: Spleen is mildly enlarged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount upper abdominal ascites.
1.Findings suspicious for tumor recurrence surrounding the ablation cavity with details provided above. Confirmation can be obtained with a contrast enhanced MRI or possibly biopsy.2.Abnormal findings in the left portal vein represents either tumor thrombus vs. flow artifact due to portal hypertension.