Suspicious lesion on outside MRI. History of hepatitis B. ABDOMEN:LIVER, BILIARY TRACT: Unremarkable liver morphology. Numerous siderotic nodules.Peripheral decreased T1 weighted signal focus in the right hepatic dome (series 17/19) is unchanged and demonstrates loss of signal on out of phase imaging without arterial enhancement or other suspicious imaging features, possibly focal fat. The peripheral lesion in the inferior aspect of the right lobe of the liver with linear margins and very low T1-weighted signal intensity demonstrates interval increase in size. It demonstrates significant loss of signal on in phase imaging. There is no definite arterial enhancement of this focus, but rather possible traversing vessel enhancement. Overall this region of signal abnormality is increased from the 7/9/2015 outside MRI and measures up to 2.6 cm. Superomedially to this lesion is a more nodular discrete lesion measuring 1.2 cm (series 11/24) demonstrating mild T2 weighted hyperintensity compared to 1.3 cm previously (series 1001/34). The lesion has restricted diffusion. There may be mild enhancement on portal venous phase imaging but no definite arterial enhancement, washout or capsule formation.Cholelithiasis without cholecystitis. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple simple appearing renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Tortuous thoracic aorta.OTHER: No significant abnormality noted.
Focus of signal abnormality of the inferior aspect of right hepatic lobe likely represents a region of increasing focal iron deposition in association with a discrete stable 1.3 cm lesion demonstrating subtle portal venous phase enhancement, T2 weighted hyperintensity and restricted diffusion without arterial enhancement, washout or capsule formation. The liver morphology is unremarkable. Overall the findings do not meet AASLD imaging criteria for HCC. At least short-interval (3-month) follow-up CT or MRI is recommended.