Wk 1, Case 4 - Review

PATIENT HISTORY: Indeterminate liver findings

MRI ABDOMEN W WO IV CONTRAST

INDICATION: Evaluate for liver findings on same day CT.

COMPARISON: None

TECHNIQUE: MRI of the abdomen was performed with and without contrast.

FINDINGS:
Hepatobiliary system: There is a 5.3 cm thick rimmed cystic structure in the left hepatic lobe with septal and rim enhancement and surrounding edematous changes compatible with an abscess. There is a similar appearing though smaller abscess more inferiorly in segment III measuring 2.1 cm. Mild hepatic steatosis is noted.

Hepatic vasculature: There is questionable small amount of portal venous thrombus within a small branch of the portal vein supplying segment III

Pancreas: Unremarkable.

Spleen: Unremarkable.

Adrenal glands: Nonspecific nodule left adrenal thickening is noted. The right adrenal gland is unremarkable.

Kidneys: The patient is status post right nephrectomy and partial left nephrectomies. There is a 1.3 cm solid enhancing mass in the lower pole of the left kidney compatible with a neoplasm.

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: No ascites.

IMPRESSION:

1. Hepatic abscesses as described with questionable peripheral branch thrombus of the portal vein.

2. Left renal neoplasm.