79-year-old female with HCV cirrhosis. Evaluate hepatic dome lesions. ABDOMEN:LIVER, BILIARY TRACT: The liver is nodular in contour with prominent fissure, compatible with cirrhotic morphology. Again noted is a 1.0 cm lesion demonstrating T2 hyperintensity, diffusion restriction, arterial enhancement (series 100, image 75) and washout with an enhancing capsule (series 9, image 271). There are additional subcentimeter arterially enhancing lesions in a cluster without washout, not changed (series 9, image 52). Previously noted segment 7 arterially enhancing lesion without evidence of washout is not present on this current examination; this was likely perfusional abnormality. SPLEEN: Mild splenomegaly and splenic varices are noted.PANCREAS: Pancreatic atrophy with ductal dilatation measuring up to 1.3 cm and side branch ectasia, unchanged compared to previous. Multiple cysts within the pancreatic head and body with the largest measuring 2.2 x 1.6 cm (series 3, image 12), unchanged. On the prior dedicated MRCP examination, this is noted to communicate with the main pancreatic duct and likely a combined type IPMN. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large hiatal hernia. Fat-containing umbilical hernia is present.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Arterially enhancing and washing out hepatic dome lesion on the background of cirrhosis, diagnostic of hepatocellular carcinoma.2.Segment 7 arterially enhancing lesion is not visualized on the current examination was likely a perfusional abnormality.3.Additional arterially enhancing subcentimeter lesions without washout not significantly changed.4.Cystic lesion in the pancreatic head. This was noted to demonstrate communication with the main pancreatic duct on the previous MRCP examination and likely combined type IPMN. 5.Large hiatal hernia.