TRIPLE PHASE CT OF LIVER (28th February 2019) HISTORY: A 58-year-old man, known case of HCV cirrhosis with HCC S/P 1 session of TACE, 1 session of HIFU (at right hepatic lobe mass) and Sorafinib treatment, was requested for follow up. TECHNIQUE: The axial scans were performed through the upper abdomen with 3.0 mm thickness in non-contrast, arterial,portovenous and delayed phases. Oral water was also administrated COMPARISON STUDY: MRI UPPER ABDOMEN from other hospital on 9th April 2018 FINDINGS: The study reveals left hepatic lobe hypertrophy and nodular liver surface, compatible with liver cirrhosis Decreased size of bulging partial lipiodol staining faint arterial enhancing lesion in right hepatic lobe segment 5/6,size 4.4 x 3.7 x 4.4 cm (WxAPxH) (previous MRI size 6.6 x 5.7 cm), which washout in portovenous phase, is consistent with HCC. Slightly decreased size of bulging partial lipiodol staining arterial enhancing lesion in left hepatic lobe segment 2/3,size 5.4 x 5.0 x 4.7 cm (WxAPXH) (previous MRI size 5.3 x 6.1 cm), which washout in portovenous phase, is consistent with HCC. No significant change of multiple small arteriai enhancing lesions which washout in portovenous phase scattered in both hepatic lobes, predominant in hepatic segment 2 and 3 are compatible with HCCs. Portal vein and its main branches have normal size and patent. No dilatation of IHD or CBD is seen. Gallbladder has smooth thin wall without evidence of gallstone. Pancreas, spleen and both adrenal glands appear normal Both kidneys show normal shape and size without stone, hydronephrosis or perinephric collection. Stomach and visualized bowel loops are unremarkable. No significant intraabdominal lymphadenopathy is visuaized. Minimal ascites at perihepatic region is noted. Multiple small pulmonary nodules scattered in both basal lungs, size up to 0.9 cm, are suggestive of pulmonary metastases Degenerative change of visualized spine without definited bony destruction is seen. IMPRESSION: -Liver chirrhosis with no significant changed multiple small HCCs scattered in both hepatic lobes, predominant in hepatic segment 2 and 3 -Decreased size of bulging partial lipiodol staining HCC in right hepatic lobe segment 5/6, size 4.4 x 3.7 x 4.4 cm -Slightly decreased size of bulging partial lipiodol staining HCC in left hepatic lobe segment 2/3, size 5.4 x 5.0 x 4.7 cm -No portal vein thrombosis or evidence of portal hypertension -Minimal ascites at perihepatic region - Multiple pulmonary metastases in both basal lungs
สวัสดีค่ะ ผลอ่านนี้แสดงถึง การที่มีโรคตับแข็งจากที่เป็นไวรัสตับอักเสบบีไม่มีการเปลี่ยนแปลงของก้อนมะเร็งขนาดเล็กๆที่ตับแต่ก็มีก้อนบางก้อนที่มีขนาดเล็กลงค่ะ ได้แก่ ที่ตับด้านขวาเป็น 4.4*3.7*4.4 เซนติเมตร และข้างซ้ายขนาด 5.4*5.0*4.7 เซนติเมตรไม่พบหลอดเลือดดำอุดตันพบน้ำในช่องท้องเล็กน้อย และพบเนื้องอกที่ลุกลามไปยังด้านล่างของปอดค่ะ