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- liver cirrhosis, portal hypertension, splenomegaly and mild ascites.
- a right hepatic lobe segment VII 16 mm focal hepatic lesion is seen. The lesion appears hyperintense on GRE T1 in-phase images with evident signal drop in the out-of-phase GRE images (chemical shift artefact); denoting intralesional fat. The lesion is T2 hyperintense.
- post-contrast, the lesion is mildly hypervascular in the arterial phase, with immediate rapid wash out in the portal venous and delayed phases with evident capsular enhancement. This lesion is small fat-containing HCC with typical imaging criteria according to the American association of the study of Liver disease (AASLD).
- another right liver lobe hypervascular focal lesion is seen at segment VII with adjacent tumorous arterio-portal shunt. The lesion shows rapid wash out with capsular enhancement in the portal venous and delayed phases. Also noted is the focal signal drop out in the out-of-phase GRE images.