Wk 3, Case 2 - Review

PATIENT HISTORY: Jaundice

MRI abdomen with and without intravenous contrast, MRCP.

INDICATION: Jaundice.

COMPARISON: None.

TECHNIQUE: MRI of the abdomen was performed with and without contrast. Coronal 3-D MRCP images were provided for interpretation.


FINDINGS:

Hepatobiliary system: There is an ill-defined mass measuring approximately 4.4 cm centered at the biliary confluence and resulting in moderate upstream intrahepatic biliary ductal dilatation, compatible with a neoplasm. The mass is mildly T2 hyperintense and enhances, with the latter most pronounced on the more delayed phase images. Gallbladder is unremarkable.

Hepatic vasculature: The main portal vein lies immediately inferior to the mass without definite findings for vascular invasion. The hepatic vasculature is patent.

Pancreas: Unremarkable.

Spleen: Unremarkable.

Adrenal glands: Unremarkable.

Kidneys: Unremarkable.

Bowel: Visualized bowel is unremarkable

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: No ascites.


IMPRESSION:

Ill-defined enhancing mass centered at the biliary confluence resulting in moderate upstream intrahepatic biliary ductal dilatation. While nonspecific, the appearance is most suggestive of a cholangiocarcinoma.