Wk 3, Case 5 - Review

PATIENT HISTORY: Choledochal cyst

Study: MRI of the abdomen with and without intravenous contrast.

INDICATION: Biliary ductal dilatation.

COMPARISON: None.

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


FINDINGS:

Liver: A few tiny liver cysts are present. There is a nonspecific 1.2 cm lesion in segment VI/VII which only manifests as a region of hypoenhancement on the arterial phase images, without correlation on any other sequences. This can be reevaluated on further surveillance MRI studies.

Gallbladder and biliary tree: Fusiform dilatation of the extrahepatic biliary tree is present. At the level of the porta hepatis this measures 2.5 cm. More caudally, the common bile duct measures 1.3 cm. No intrahepatic biliary ductal dilatation is seen. No choledocholithiasis or obstructing biliary mass is identified. Cholelithiasis is noted.

Hepatic vasculature: Patent.

Pancreas: Unremarkable.

Spleen: Unremarkable.

Adrenal glands: Unremarkable.

Kidneys: A few tiny renal cysts are present including a left renal cyst which contains internal debris.

Bowel: Visualized bowel is unremarkable.

Upper abdominal lymph nodes: No lymphadenopathy.

Peritoneum: No ascites.


IMPRESSION:

Fusiform dilatation of the extrahepatic biliary tree without an obstructing mass identified. The possibility of a type I choledochal cyst should be considered.