Date : 00.00.00
Name of the Patient : Abc Xyzai Plmn / M / 41 yrs.
Referred by : Dr. Abc Xyzsai. Examination : M.R.Cholangiogram.
CLINICAL PROFILE : C/O pain in the abdomen since 4 months.
C/O jaundice 3 months back.
MR Cholangiogram was performed. 7 mm thick T1 Weighted and T2 Weighted axial images. 8 mm thick T2 Weighted coronal images.OBSERVATION :
There is an ill-defined, hyperintense signal on the T1 Weighted images in the right lobe of the liver, anteriorly, posteriorly and superiorly. This signal is suppressed on the T2 Weighted images. There is a very small, subcentimeter, hyperintense lesion on the T2 Weighted images in the lateral segment of the left lobe of the liver (scan 103.7). This lesion appears hypointense on the T1 Weighted images.
There is a diffuse, ill-defined, hypointense signal on the T1 Weighted images along the course of the intrahepatic portal radicles in the hepatic parenchyma. This signal is nearly isointense to the normal hepatic parenchyma on the T2 Weighted images.
On the MRCP, the intrahepatic biliary radicles appear slightly attenuated and stretched. The right and left hepatic ducts, the common hepatic duct and the common bile duct are well identified. The common bile duct measures approximately 7.0 mms in its maximum transverse dimension. The pancreatic duct is not dilated.
The gall bladder is well distended without intrinsic lesion.
The pancreas appear normal in bulk and signal characteristics. The calcific densities identified in the head of the pancreas on the CT scan images are not well appreciated on the MR images.
Mild splenomegaly is noted.
Both the visualized kidneys and adrenal glands show normal signal intensity.
There are no abnormally enlarged lymph nodes noted. There is no free fluid in the abdomen.
1. Diffuse altered signal along the intrahepatic portal radicles is not specific for a single etiology. Intrahepatic cholangiocarcinoma/periportal edema (? fibrosis) /cholangitis may be considered as differential diagnosis. The intrahepatic biliary radicles appear slightly stretched.
2. Diffuse altered signal in the right lobe of the liver as described, may suggest fatty infiltration.
3. A subcentimeter lesion in the lateral segment of the left lobe of the liver is a ? hepatic cyst, ?? cystic metastasis.