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What Does This Following MRI Report Indicate?
Question: Hello Doctor,
I went to see a liver surgeon at XXXXXXX XXXXXXX He was confident that liver surgery would remove the cancer.I had a cat scan there.Their committee reviewed my case and wanted an MRI to confirm their findings.I will go in to have surgery on May 18th and 40% of my liver will be removed.Here are the results of the MRI.What do you think?
XXXXXXX
PROCEDURE: MRI ABDOMEN (W+WO) (CPT=74183)
COMPARISON: None.
INDICATIONS: History of colon cancer, metastatic to the liver.
TECHNIQUE: Multiplanar T1 and T2 weighted images are acquired including fat suppressed T2 weighted fast spin echo, in and out of phase gradient echo, FIESTA, and single shot fast spin echo T2 weighted sequences. Post infusion 3D T1 weighted gradient
echo (LAVA) sequences were acquired after the intravenous demonstration of 7 cc of Eovist.
FINDINGS:
LIVER: There are 3 intrahepatic lesions within the posterior segment of the right lobe liver that are adjacent to one another. The most cephalad lesion measures 3.5 x 3.2 cm. Slightly inferior and lateral to this, the second lesion measures 3.1 x 2.2
cm. The third lesion, slightly more inferior and medial measures 3.2 x 2.2 cm. All 3 lesions are of low T1, intermediate to high T2 signal and are available mild heterogeneous post contrast-there is evidence of cholelithiasis. There is mild nonspecific
pericholecystic fluid. No biliary ductal dilatation noted. No gallbladder wall thickening.
PANCREAS: Normal. No lesion, fluid collection, ductal dilatation, or atrophy.
SPLEEN: There is borderline hepatomegaly measuring 12.6 cm.
KIDNEYS: Normal. No mass or obstruction.
ADRENALS: Normal. No mass or enlargement.
AORTA/VASCULAR: Normal. No aneurysm or dissection.
RETROPERITONEUM: Normal. No mass or adenopathy.
BOWEL/MESENTERY: Normal. No visible mass, obstruction, or bowel wall thickening.
ABDOMINAL WALL: Normal. No mass or hernia.
BONES: Normal. No bony lesion or fracture.
LUNG BASES: Normal. No visible pleural disease. Lung bases not well assessed with MRI.
OTHER: Negative.
Impression
CONCLUSION:
1. There are 3 adjacent intrahepatic masses within the posterior segment of the right lobe of the liver as described above, most consistent with metastatic lesions. Correlation with prior imaging is recommended to assess for progression versus
improvement in disease.
2. There is evidence of cholelithiasis and mild pericholecystic fluid. However no evidence of gallbladder wall thickening or biliary ductal dilatation. The possibility of a mild cholecystitis cannot be excluded. Please correlate clinically.
3. Borderline splenomegaly measuring 12.6 cm.
Dictated by: Amaar XXXXXXX DO on 4/13/2017 at 10:00
Approved by: Amaar XXXXXXX DO
Component Results
I went to see a liver surgeon at XXXXXXX XXXXXXX He was confident that liver surgery would remove the cancer.I had a cat scan there.Their committee reviewed my case and wanted an MRI to confirm their findings.I will go in to have surgery on May 18th and 40% of my liver will be removed.Here are the results of the MRI.What do you think?
XXXXXXX
PROCEDURE: MRI ABDOMEN (W+WO) (CPT=74183)
COMPARISON: None.
INDICATIONS: History of colon cancer, metastatic to the liver.
TECHNIQUE: Multiplanar T1 and T2 weighted images are acquired including fat suppressed T2 weighted fast spin echo, in and out of phase gradient echo, FIESTA, and single shot fast spin echo T2 weighted sequences. Post infusion 3D T1 weighted gradient
echo (LAVA) sequences were acquired after the intravenous demonstration of 7 cc of Eovist.
FINDINGS:
LIVER: There are 3 intrahepatic lesions within the posterior segment of the right lobe liver that are adjacent to one another. The most cephalad lesion measures 3.5 x 3.2 cm. Slightly inferior and lateral to this, the second lesion measures 3.1 x 2.2
cm. The third lesion, slightly more inferior and medial measures 3.2 x 2.2 cm. All 3 lesions are of low T1, intermediate to high T2 signal and are available mild heterogeneous post contrast-there is evidence of cholelithiasis. There is mild nonspecific
pericholecystic fluid. No biliary ductal dilatation noted. No gallbladder wall thickening.
PANCREAS: Normal. No lesion, fluid collection, ductal dilatation, or atrophy.
SPLEEN: There is borderline hepatomegaly measuring 12.6 cm.
KIDNEYS: Normal. No mass or obstruction.
ADRENALS: Normal. No mass or enlargement.
AORTA/VASCULAR: Normal. No aneurysm or dissection.
RETROPERITONEUM: Normal. No mass or adenopathy.
BOWEL/MESENTERY: Normal. No visible mass, obstruction, or bowel wall thickening.
ABDOMINAL WALL: Normal. No mass or hernia.
BONES: Normal. No bony lesion or fracture.
LUNG BASES: Normal. No visible pleural disease. Lung bases not well assessed with MRI.
OTHER: Negative.
Impression
CONCLUSION:
1. There are 3 adjacent intrahepatic masses within the posterior segment of the right lobe of the liver as described above, most consistent with metastatic lesions. Correlation with prior imaging is recommended to assess for progression versus
improvement in disease.
2. There is evidence of cholelithiasis and mild pericholecystic fluid. However no evidence of gallbladder wall thickening or biliary ductal dilatation. The possibility of a mild cholecystitis cannot be excluded. Please correlate clinically.
3. Borderline splenomegaly measuring 12.6 cm.
Dictated by: Amaar XXXXXXX DO on 4/13/2017 at 10:00
Approved by: Amaar XXXXXXX DO
Component Results
Brief Answer:
Surgical resection is the only option present.
Detailed Answer:
Hi there,
Thanks for asking query on this forum.
Have gone through the reports of your MRI. Don't worry if performed well post resection prognosis of metastatic masses in liver is good.MRI reports shows that all three masses are well localized. Surgery results are very good on well localized masses.
Frankly speaking surgery is the only option you have.
Chemotherapy is not successful in your case.
A person can survive even with 40% liver functioning.So don't worry too much you will be fine if resection surgery is done accurately.
Even is worst case scenario liver transplant can be done and is very successful these days.
Don't panic rest assured most likely you will be fine soon.
In case you have any specific query feel free to question.
Thanks.
Surgical resection is the only option present.
Detailed Answer:
Hi there,
Thanks for asking query on this forum.
Have gone through the reports of your MRI. Don't worry if performed well post resection prognosis of metastatic masses in liver is good.MRI reports shows that all three masses are well localized. Surgery results are very good on well localized masses.
Frankly speaking surgery is the only option you have.
Chemotherapy is not successful in your case.
A person can survive even with 40% liver functioning.So don't worry too much you will be fine if resection surgery is done accurately.
Even is worst case scenario liver transplant can be done and is very successful these days.
Don't panic rest assured most likely you will be fine soon.
In case you have any specific query feel free to question.
Thanks.
Above answer was peer-reviewed by :
Dr. Kampana
Hi Doctor,
My oncologist said that some of the microscopic lesions that were present when I was operated on last May may reappear.The liver surgeon after looking at the recent MRI and cat scan said not to worry about those as they are no longer present and the chemotherapy killed them.Both doctors told me there is no cancer shown outside of my liver.
XXXXXXX
My oncologist said that some of the microscopic lesions that were present when I was operated on last May may reappear.The liver surgeon after looking at the recent MRI and cat scan said not to worry about those as they are no longer present and the chemotherapy killed them.Both doctors told me there is no cancer shown outside of my liver.
XXXXXXX
Brief Answer:
Follow up answer.
Detailed Answer:
Hello Dear,
Welcome again.
All the three masses in MRI are well localised. Well localised means that their borders shape and size can be very well appreciated in MRI.
What your oncologist said was a probability and What me and your liver surgeon is saying is a fact(As we have MRI reports with us).
I hope you have got your answer.When we have the report with us then probability makes no sense.
I am sorry but one thing i can't get is that earlier you mentioned you are planned to be operated on 18 may 2017 and now you have mentioned that last time when i was operated in may.
I am taking it as that you were operated in May 16 followed by chemotherapy and now again planned for resection in May 17.
Please do correct me if i am wrong otherwise the advice has already been given.
Don't panic.
MRI shows localized lesion.
I think you will be fine soon post resection.
"Rare thing do happen but very rarely".
Good luck and Keep smiling.
Follow up answer.
Detailed Answer:
Hello Dear,
Welcome again.
All the three masses in MRI are well localised. Well localised means that their borders shape and size can be very well appreciated in MRI.
What your oncologist said was a probability and What me and your liver surgeon is saying is a fact(As we have MRI reports with us).
I hope you have got your answer.When we have the report with us then probability makes no sense.
I am sorry but one thing i can't get is that earlier you mentioned you are planned to be operated on 18 may 2017 and now you have mentioned that last time when i was operated in may.
I am taking it as that you were operated in May 16 followed by chemotherapy and now again planned for resection in May 17.
Please do correct me if i am wrong otherwise the advice has already been given.
Don't panic.
MRI shows localized lesion.
I think you will be fine soon post resection.
"Rare thing do happen but very rarely".
Good luck and Keep smiling.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Doctor,
12" of my colon was removed in XXXXXXX of 2016.Chemo started one month later and now I have had 18 treatments.I have not had chemo for the last month as I must wait six weeks without chemo before surgery
XXXXXXX
12" of my colon was removed in XXXXXXX of 2016.Chemo started one month later and now I have had 18 treatments.I have not had chemo for the last month as I must wait six weeks without chemo before surgery
XXXXXXX
Brief Answer:
Follow up.
Detailed Answer:
Hi Again.
Ok XXXXXXX no problems.
All you need is to remain motivated.
Go for the resection surgery.Don't worry you can live with even 40% of liver also.
I wish you a great luck for surgery.
As all three masses are well localised chances of success are very high.
After having resection and 18 chemos You have proved yourself as a person with a lot of will power, so I am sure that you will recover soon enough.
I wish you a very speedy recovery.
Take my words you will be fine soon.
Regards.
Follow up.
Detailed Answer:
Hi Again.
Ok XXXXXXX no problems.
All you need is to remain motivated.
Go for the resection surgery.Don't worry you can live with even 40% of liver also.
I wish you a great luck for surgery.
As all three masses are well localised chances of success are very high.
After having resection and 18 chemos You have proved yourself as a person with a lot of will power, so I am sure that you will recover soon enough.
I wish you a very speedy recovery.
Take my words you will be fine soon.
Regards.
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Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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