Quad phase liver CT:
- non-contrast phase:
- cirrhotic liver
- splenomegaly
- hypodense right liver lobe mass
- arterial phase:
- large, well-defined right lobe mass with heterogenous hyperenhancement and areas of necrosis
- venous phase:
- enlarged IVC with hypodense filling defect of its intrahepatic as well as suprahepatic portions keeping with IVC thrombosis
- right branch of portal vein is dilated and completely filled with hypodense thrombus (enhancing, tumour thrombus)
- patent lumen of left branch and main trunk portal vein as well as SMV
- recanalised paraumbilical vein with portosystemic collaterals
- delayed phase shows relative hypoenhancement of the mass (wash out)
Mild abdominal ascites is noted.