Male 64 years old with cirrhosis. Assess liver lesions. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. No biliary ductal dilatation or ascites. Hepatic vasculature is patent. Splenorenal shunting is noted.Hepatic segment 5/8 exophytic lesion measures 4.1 x 3.1 cm, an exophytic segment 4 lesion measures 1.7 x 1.3 cm, a segment 7 lesion measures 1.6 x 1.5 cm and a segment 2/4A lesion measures 1.5 x 1.4 cm (series 9, images 109, 117, 118, and 126). All lesions are mildly T2 hyperintense with arterial enhancement and washout and are suspicious for hepatocellular carcinoma.SPLEEN: The spleen measures 12 cm in length.PANCREAS: The pancreas enhances homogeneously. There is no pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A subcentimeter T1 hyperintense lesion in the midpole the left kidney does not enhance and is compatible with a proteinaceous/hemorrhagic cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Anterior abdominal wall ventral hernia contains only mesenteric fat, unchanged.
1.Multiple lesions suspicious for hepatocellular carcinoma. The largest is a 4.1 x 3.1 cm exophytic lesion segment 5/8.2.Evidence of portal hypertension with splenorenal shunting