57-year-old male. Evaluate subcentimeter hypodensity seen on CT scan in patient with history of pancreatic cancer, status post resection in 2015. Concern for metastasis. ABDOMEN:LIVER, BILIARY TRACT: Loss of signal intensity on the out of phase imaging compatible with diffuse hepatic steatosis.At the hepatic dome, there are two faintly T2 hyperintense lesions demonstrating restricted diffusion (axial series 9 images 112, 116) and peripheral enhancement consistent with metastases (axial series 13 images 340, 346). These lesions were noted on the 9/23/2016 CT exam, and the sizes have slightly increased in the interval with reference measurements listed below.There are punctate arterially enhancing foci in the inferior peripheral right hepatic lobe that are only seen on the arterial phase and are most compatible with perfusional variants.SPLEEN: No significant abnormality noted.PANCREAS: Stable surgical changes status post Whipple. There is mild dilatation of the pancreatic duct measuring 5 mm in diameter. A 1.1 x 0.8 cm pancreatic tail cyst is unchanged (axial series 600 image 21).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis. In the right lower renal pole, there is a 2 x 2 centimeters simple cyst. Other subcentimeter T2 hyperintense foci of the right renal parenchyma are too small to fully characterize.RETROPERITONEUM, LYMPH NODES: Similar mildly prominent periportal lymph nodes.BOWEL, MESENTERY: Surgical changes from Whipple procedure. No acute abnormality.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 10/6/2016 08:59:21)RIGHT HEPATIC LESION 1 - POSTERIOR: 0.9 x 1.0 cm (Image 116, Series 9); (Image 346, Series 13); 0.8 x 0.8 cm on prior (9/23/2016) (Image 66, Series 9).RIGHT HEPATIC LESION 2 - LATERAL: 0.5 x 0.7 cm (Image 112, Series 9); (Image 340, Series 13); 0.4 x 0.4 cm on prior (9/23/2016) (Image 63, Series 9).
Slight interval enlargement of known two hepatic dome lesions, which demonstrate peripheral enhancement consistent with metastases. Reference measurements listed above.