1475202 tn?1536270977

CT Scan

Anyone care to elaborate? I really appreciate it. Most of it makes sense to me but I got confused with: FINDINGS #2. "The liver is diffusely heterogeneously enhancing."

I sent a message to my hepatologist asking the same question and her reply was: "It is enhancing in a variable fashion. This can be seen with severe fibrosis as he has- "

Well whats that mean?? Haha!

Thanks for any help,


HISTORY: 42-year-old male with a history of cirrhosis


TECHNIQUE: Multidetector axial images were obtained of the abdomen and pelvis before and following the intravenous administration of 100 mL Omnipaque 350. Coronal and sagittal reformatted images as well as 3-D MIP reconstructions were provided.

COMPARISON: 12/5/2013


1. The lung bases are clear save for atelectasis and/or scarring within the lingula.

2. The liver is shrunken and demonstrates a lobulated surface contour in keeping with cirrhosis. The liver is diffusely heterogeneously enhancing. The hypervascular focus between the right and left hepatic lobes described on 8/26/2013 is only faintly visible on the present exam. Two additional hypervascular foci in the dome of the liver described on previous studies are not definitively identified on the present exam. There is no new hypervascular focus.

3. The spleen measures up to 21.2 cm in greatest axial dimension. There are small gastroesophageal varices as well as a small recanalized umbilical vein. Omental collateral vessels are contained within an umbilical hernia as before. Reactive, borderline in size periportal, retroperitoneal, and mesenteric lymphadenopathy is present. The SMV, splenic vein, and portal vein are patent.

4. There is continued thickening of the retroperitoneal fascial planes as well as haziness of the mesentery, likely indicating third spacing of fluid. There is no ascites.

5. There is cholelithiasis as before within a contracted gallbladder. The adrenal glands, kidneys, and pancreas are normal. The bowel is normal in course and caliber without obstruction.

6. There are no lytic or blastic bone lesions.


1. Findings of cirrhosis and portal hypertension as before including gastroesophageal varices and splenomegaly. There are islands of steatosis and capsular retraction suggestive of confluent hepatic fibrosis. A previously described faint hypervascular focus at the junction of the right and left lobes of the liver is only faintly visible on the present exam. There is no new hypervascular focus.

2. Cholelithiasis.
Best Answer
Avatar universal
Hi Randy -

Sounds like a perfusional effect due to different blood flow rates between the liver lobes. Simply caused by more contrast ending up in a given region of the liver wrt the rest as the arterial, then venous blood flow works through the parenchyma and fibrotic tissues. My liver does it as well but in a spectacular fashion due to my advanced PSC liver disease (PSC tends to be "patchy" in its progression). Certainly expect there to be some nodular type of enhancement as well but I think they're referring to a regional effect here.

Btw, good work you've been doing helping so many others on this site. Hope things keep going well for you.
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1475202 tn?1536270977
Thank you for such a helpful reply!

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