Date : 00.00.00
Name of the Patient : Abc Xyzi Prajalmn / F / 60 yrs.
Referred by : Dr. Abc Xyzdeo. Examination : M.R.Cholangiogram.
CLINICAL PROFILE : C/O pain in the abdomen since 2 months.
H/O jaundice since 1 month.
MR Cholangiogram was performed. 7 mm thick T1 Weighted and T2 Weighted axial images. 8 mm thick T2 Weighted coronal images.OBSERVATION :
There is seen an intermediate signal intensity mass lesion on the T1 Weighted images in the region of the porta hepatis, which turns hyperintense on the T2 Weighted images. There is thickening of the wall of the fundus and anterior margin of the gall bladder. The gall bladder appears slightly distended. A calculus is noted in the fundus of the gall bladder.
There is resultant dilatation of the intrahepatic biliary radicles upto the level of the porta hepatis. The common hepatic duct also seems to be involved whereas the right and the left hepatic duct are identified separately. The common bile duct and the cystic duct are not identified. The mass lesion at the porta appears slightly more towards the right hepatic duct.
The pancreas appears unremarkable. The pancreatic duct is not dilated.
There is seen an approximately 2.0 cms diameter sized hypointense lesion on the T1 Weighted images in the right lobe of the liver peripherally (scans 102/7, 8). This lesion appears hyperintense on the T2 Weighted images. No obvious satellite lesions are noted.
There is evidence of thickening of the limbs of the right adrenal gland.
There are small lymph nodes identified in the interaorticocaval and retrocaval region.
Both the visualized kidneys and spleen are normal in size and signal intensity.
There is no free fluid noted.
1. Thickening of the wall of the gall bladder along its fundus and anterior wall with a soft tissue mass lesion at the porta hepatis may suggest a neoplasm of the gall bladder with metastasis at the porta hepatis. There is resultant obstruction of the intrahepatic biliary radicles at the level of the porta hepatis with dilatation of the same. The common hepatic duct is not visualized.
A cholangiocarcinoma may be considered as a differential diagnosis.
2. A 2.0 cms diameter sized lesion in the right lobe of the liver, peripherally is not specific for a single etiology, ? hepatic cyst, ?? cystic metastasis.
3. Enlarged right adrenal gland is of (? etiology, ? secondaries).