Wk 1, Case 3 - Review

PATIENT HISTORY: Hepatocellular carcinoma (LR 5)

MRI abdomen with and without intravenous contrast

Indication: Cirrhosis.

COMPARISON: None.

TECHNIQUE: MRI of the abdomen was performed with and without contrast

FINDINGS:

Liver: Cirrhotic liver morphology is present. Hepatic observations are as follows:

- In segment IVa, there is a 2.1 cm observation with nonrim arterial phase hyperenhancement, washout and pseudocapsule (LR 5)

- In segment VIII, there is a 1.5 cm observation with nonrim arterial phase hyperenhancement, and washout, without definite pseudocapsule (LR 5).

- There are a few additional scattered subcentimeter observations which demonstrate arterial hyperenhancement, without washout or pseudocapsule (LR 3).

Gallbladder and biliary: Unremarkable

Pancreas: A 0.5 cm nonspecific pancreatic body cystic structure may represent a side branch intraductal papillary mucinous neoplasm or the sequela prior pancreatitis. No dilatation of the main pancreatic duct is seen.

Spleen: Mild splenomegaly is present with the spleen measuring 14.3 cm increased craniocaudal dimension.

Adrenal glands: Unremarkable.

Kidneys: A few small renal cysts are noted.

Bowel: Visualized bowel is unremarkable. Nonspecific thickening of the gastric rugal folds is noted.

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: Small amount of ascites is present.

Vasculature: A recanalized paraumbilical vein is present and a small splenorenal shunt is seen compatible with portal hypertension.

IMPRESSION:

Two LR 5 observation size described.