The left hepatic lobe is small with atrophic segments II and III and is mostly occupied by a circumscribed mass that shows low T1, mildly elevated T2, and increased DWI signal. Post-contrast, the lesion shows intense hyperenhancement on the arterial phase that gets homogeneous to the background parenchyma on portal venous phase, and starts to wash out on the delayed/intermediate phase, showing mostly low signal compared to the background liver on the hepatobiliary phase. This washout is concerning for a malignant process. Within the lesion, a note is made to dilated intrahepatic ducts, as previously demonstrated on the external scan. No fat demonstrated within the lesion.
Focal area of arterial hyperenhancement in segment VI without washout. There is no corresponding abnormal DWI signal and homogeneous uptake of hepatobiliary contrast at 20 minutes. No mass is visible. No other focal liver lesions identified. The appearances are therefore not those of metastasis and most in keeping with a THID/THAD.
The pancreas appears normal. Small left adrenal gland adenoma and normal right adrenal gland. There are features suggestive of splenectomy and a 3.1 cm splenunculus in the splenic bed. Apart from a simple cortical cyst on the left, the imaged kidneys are normal. There is no lymphadenopathy or free fluid within the superior abdomen.
Conclusion: Left hepatic lobe mass has indeterminate imaging features and is concerning for a malignant tumour. Further hepatobiliary discussion with a view for US-guided core-biopsy is recommended.