History of HCV and alcohol cirrhosis. 2.9 cm right liver lesion. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic nodular liver morphology. Small volume perihepatic ascites. No intra or extrahepatic biliary ductal dilatation. The vessels are patent. Cholelithiasis without cholecystitis. Segment 6/7 lesion measuring 3.2 x 2.8 cm demonstrating intrinsic T1 weighted hyperintensity (series 801/57) with regions of T2-weighted hypointensity posteriorly and T2-weighted hyperintensity anteriorly and mild restricted diffusion. There is arterial-enhancement on subtraction images (series 902/272). The intrinsic T1 weighted hyperintensity limits evaluation for washout on delayed images although it is suspected given the subtraction images.Recanalized periumbilical vein. The vessels are patent.SPLEEN: The spleen measures 10.7 cm in craniocaudal dimension. Minimal perisplenic fluid.PANCREAS: No significant abnormality noted.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: Partially imaged incisional hernia containing fluid better seen on prior CT.OTHER: Body wall collateral vessels.
The segment 6/7 3.2 cm lesion demonstrates intrinsic T1 weighted hyperintensity and arterial enhancement. Intrinsic T1 weighted hyperintensity limits evaluation for washout on delayed images although it is suspected given the subtraction images. The findings are suspicious for hepatocellular carcinoma.Cirrhosis with trace ascites. 