ke/sb/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyza Warglmn / F / 50 yrs.
Referred by : Dr. Abc Xyzdeo. Examination : M.R.Cholangiogram.
CLINICAL PROFILE : H/O vomiting, indigestion and weight loss since 1 year.
Now C/O itching all over body with jaundice.
EXAMINATION :
MR Cholangiogram was performed. 7 mm thick T1 Weighted and T2 Weighted axial images. 7 mm thick T2 Weighted coronal images.OBSERVATION :
There is an intermediate signal intensity lesion on the T1 Weighted images along the course of the portal vein and its right and left branches (se/im: 102/10). This is seen to turn heterogeneously hyperintense on the T2 Weighted images.
There is mild dilatation of the intrahepatic biliary radicles, upto the level of the porta hepatis and the junction of the right and left hepatic ducts. The common hepatic duct is not visualized.
There is mild hepato-splenomegaly, without signal change.
The gall bladder is small and contracted and shows a subtle hyperintense signal on the T1 Weighted and T2 Weighted images and may represent sludge.
The pancreas and adrenals are normal in size and shape. Scan-00001
The common bile duct is well-visualized in it's entire course upto it's insertion into the duodenum and is of normal calibre. The visualized pancreatic duct is unremarkable.IMPRESSION :
1. Altered signal along the course of the portal veins, bilaterally with mild dilatation of the intrahepatic biliary radicles upto the level of the porta hepatis is not specific for a single etiology.
The possibilities to be considered are :
a. Neoplastic process like cholangiocarcinoma.
b. Infective process - Cholangitis.
2. Small contracted gall bladder with altered signal may represent sludge.