Wk 3, Case 4 - Review

PATIENT HISTORY: Right upper quadrant pain

MRI abdomen with and without intravenous contrast, MRCP.

INDICATION: Right upper quadrant pain.

COMPARISON: None.

TECHNIQUE: MRI of the abdomen was performed without contrast. Coronal 3-D
MRCP images were obtained.

FINDINGS:

Hepatobiliary: Multifocal segmental regions of intrahepatic biliary ductal dilatation narrowing are redemonstrated compatible with history of sclerosing cholangitis. There are no liver lesions imaging features of hepatocellular carcinoma or cholangiocarcinoma. There are few non masslike regions of arterial hyperenhancement without correlation on the remaining sequences, possibly perfusional. No abscess is seen. No choledocholithiasis is seen. The hepatic vasculature is patent.

Pancreas: Unremarkable.

Spleen: Splenomegaly is present measuring 16.8 cm in craniocaudal dimension.

Adrenal glands: Unremarkable.

Kidneys: Unremarkable.

Bowel: Visualized bowel is unremarkable.

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: Trace free fluid is noted.

Other: There is unchanged narrowing of the proximal celiac artery with poststenotic dilatation and prominent pancreaticoduodenal arteries, of uncertain clinical significance.

IMPRESSION:

1. Findings compatible with sclerosing cholangitis as described.

2. No evidence for cholangiocarcinoma or hepatocellular carcinoma.

3. Splenomegaly.