Name of the Patient : Abc XyzVallmn / F / 30 yrs.
Referred by : Dr. Abc Xyzshi. Examination : M.R.Cholangiogram.
CLINICAL PROFILE : C/O pain in the abdomen since 5 months with vomiting.
C/O jaundice since 2 months.
ERCP s/o advanced malignancy - cholangiocarcinoma or residual carcinoma of Gall Bladder.
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 intermediate signal intensity lesion on the T1 Weighted images along the course of the distal right hepatic duct, left hepatic duct and at the porta hepatis. This is seen to turn heterogeneously hyperintense on the T2 Weighted images. There is resultant narrowing of the left hepatic duct and the left sided biliary radicles with slight dilatation of the right hepatic duct. The extrahepatic portion of the common bile duct is not well visualized. The common hepatic duct and the cystic duct are not identified on this study.
The liver is normal in size, shape and position. There is no local or diffuse area of altered signal intensity. The intrahepatic venous architecture is normal.
Both the visualized kidneys, pancreas, adrenals and spleen are unremarkable. The gall bladder is not well-identified.
The visualized pancreatic duct is not dilated.
Altered signal along the course of the right hepatic duct, left hepatic duct and at the porta hepatis with non-visualization of the extrahepatic portion of the common bile duct and common hepatic duct and narrowing of the left sided biliary radicles may suggest cholangiocarcinoma.