History of chronic hepatitis C and cirrhosis. Presents for HCC screening. ABDOMEN:LIVER, BILIARY TRACT: Prominent hepatic fissures and diffuse reticular T2 hyperintensity compatible with chronic liver disease and fibrosis. Stable punctate cyst in segment VI.The reference segment 4 lesion measures 1.1 x 1.0 cm (series 11/26), compared to approximately 1.7 x 1.3 cm previously and demonstrates poor arterial phase enhancement but no washout.The reference segment 5 lesion is grossly unchanged measuring approximately 1.3 x 1.2 cm (series 11/35), compared to 1.5 x 1.4 cm previously, again with poor arterial enhancement but no washout.These lesions demonstrate no abnormal T2-weighted signal intensity or restricted diffusion.No new arterial enhancing lesion.Stigmata of portal hypertension including borderline splenomegaly and recanalization of the periumbilical vein and body wall collaterals.The portal vein is patent.Cholelithiasis in a hydropic gallbladder without specific evidence of acute inflammation. SPLEEN: Borderline splenomegaly measuring 15 cm in length. Stable nonspecific subcentimeter hypodense splenic lesion.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: Scattered degenerative endplate changes of the thoracic lumbar spine.OTHER: No significant abnormality noted.
1.Accounting for technical differences no significant change in the poorly enhancing hepatic lesions without washout. These do not meet imaging criteria for HCC.2.Cirrhotic liver morphology with fibrosis. No new liver lesion.3.Borderline splenomegaly and recanalized periumbilical vein. 4. Cholelithiasis in a hydropic gallbladder without specific evidence of acute inflammation. 