Wk 3, Case 1 - Review

PATIENT HISTORY: Abdominal pain

MRI abdomen with and without intravenous contrast.

INDICATION: Abdominal pain.

COMPARISON: None.

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


FINDINGS:

Hepatobiliary system: The gallbladder is distended, thick-walled, contains gallstones, and there is mild pericholecystic inflammation consistent with acute cholecystitis. There is no biliary dilatation or choledocholithiasis. There is hepatic steatosis.

Hepatic vasculature: Patent.

Pancreas: Few subcentimeter pancreatic cystic lesions are present without pancreatic ductal dilatation present. These may represent side branch intraductal papillary mucinous neoplasms and/or the sequela prior pancreatitis.

Spleen: The spleen is at the upper limits of normal for size.

Adrenal glands: Unremarkable.

Kidneys: A few renal cysts are present, some of which contain internal debris.

Bowel: Visualized bowel is unremarkable.

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: No ascites.


IMPRESSION:

1. Findings consistent with acute cholecystitis.

2. Hepatic steatosis.

3. Nonspecific subcentimeter pancreatic cystic lesions which may represent side branch intraductal papillary mucinous neoplasms and/or the sequela prior pancreatitis. Per ACR guidelines, follow-up MRI in one year could be performed to ensure stability in size and appearance.