Wk 1, Case 9 - Review

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Report

TECHNIQUE: MRI CHOLANGIOPANCREATOGRAPHY (MRCP) WITH AND WITHOUT CONTRAST

TECHNIQUE: Multiplanar MR imaging of the abdomen was performed using T1, T2, fat saturated, and diffusion weighted techniques. 2D and 3D MRCP sequences were performed. Dynamic multiphase imaging was also performed after administration of an intravenous gadolinium contrast agent.

COMPARISON: CT ABDOMEN/PELVIS WITH CONTRAST 2023-Jun-08

FINDINGS:

Lower chest: Mild bibasilar subsegmental dependent atelectasis. No effusion.

Liver: No suspicious lesion.

Biliary: Intrahepatic and common hepatic duct dilation secondary to an impacted 3.3 cm stone in the gallbladder neck causing mass effect on the common hepatic duct (9:57). 0.9 cm calculus in the upper common bile duct, inferior to which the common bile duct is decompressed. Dilated gallbladder with cholelithiasis, increased gallbladder wall thickness, mild gallbladder wall edema, and mild pericholecystic fluid.

Spleen: No splenomegaly.

Pancreas: No masses or ductal dilatation.

Adrenal glands: No nodules.

Kidneys/ureters: No solid masses or hydronephrosis.

Bowel: No dilation. Colonic diverticulosis.

Peritoneum/retroperitoneum: No masses or fluid.

Lymph nodes: No lymphadenopathy.

Vessels: No abdominal aortic aneurysm.

Bones/soft tissues: No suspicious bone lesions.

IMPRESSION:

Impacted 3.3 cm calculus in the gallbladder neck causes mass effect on the common hepatic duct and causes intrahepatic and common hepatic duct dilation with findings suspicious for acute cholecystitis.

Faculty

Laura L Avery, MD

Assistant Professor of Emergency Radiology Harvard Medical School

Massachusetts General Hosptial

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Wk 1, Case 9 - Review