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TECHNIQUE: Multiplanar, multisequence MR evaluation was performed of
the abdomen. Axial VIBE preceding and following gadolinium contrast,
coronal VIBE.
Contrast: 6.5 mm Gadavist.
COMPARISONS: Ultrasound dated 10/19/2016.
DATE: 11/16/2016 12:59 PM
FINDINGS:
Lung Bases: Lung bases are clear. Inferior heart is normal. No
pleural effusion,
Abdomen:
Liver: Heterogeneous signal intensity with a nodular contour.
Liver observation 1: T2 hypointense ovoid lesion (10:18) which shows
T1 hyperintensity on noncontrast phase (1400:66), shows mild
homogeneous arterial enhancement (1401:64) with washout on the
delayed phase (1404:69), and measures 2.6 x 2.4 cm. Associated
pseudocapsule. (LI-RADS 5)
Liver observation 2: There is a T1 hyperintense lesion within segment
II measuring 1 cm (1400:22) which shows no postcontrast enhancement
and is T2 isointense. (LI-RADS 2)
Liver observation 3: There is nodular subtle postcontrast enhancement
along the periphery of segment VI only seen on the portal venous
phase which is isodense on the other phases. Finding is isointense on
T2.(LI-RADS 3)
No additional enhancing lesions are identified throughout the liver.
No additional areas of washout.
Hepatic vasculature: Conventional celiac anatomy. Dilated portal
veins are widely patent. Dilated splenic artery and vein. Multiple
perisplenic, perigastric, and periesophageal varices along with
recanalization of the umbilical vein.
Gallbladder: No gallstones, wall thickening, or pericholecystic fluid.
Bile ducts: Normal. No intra or extra hepatic bile duct dilation.
Pancreas: No focal lesions, ductal dilation, or distal atrophy.
Spleen: Enlarged measuring 20 cm craniocaudally.
Adrenal Glands: No adrenal nodules.
Kidneys: Normal. No pelvocaliectasis or solid masses.
Stomach and small bowel: Incompletely distended grossly normal
stomach. Visualized small bowel is normal in caliber.
Colon: No masses or segmental wall thickening throughout the
visualized colon.
Mesentery: Normal.
Lymph nodes: None enlarged.
Vascular structures: The aorta and IVC show normal flow voids and
postcontrast filling.
Free fluid: Tiny volume in the bilateral subphrenic spaces.
Abdominal wall: No hernias.
Bones: Normal marrow signal intensity.
IMPRESSION:
Hepatic steatosis and portal hypertension with the previously seen
segment VI lesion consistent with HCC (LR5).
Communication:
**CRITICAL TEST** ERIK NESS was notified by TRACY J ROBINSON of the
above findings at 1418 hrs. on 11/16/2016 and has accepted
responsibility for followup. |
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发表于 2016-12-10 09:37
