57-year-old female with elevated alkaline phosphatase and abdominal pain. ABDOMEN:LUNG BASES: Multiloculated right and left pleural effusions are again noted and not significantly changed compared to the 4/14/2016 CT chest examination. Additionally, again noted is partially visualized right lower lobe opacities.LIVER, BILIARY TRACT: Hepatomegaly with liver measuring approximately 20 cm. Again noted is a mildly distended gallbladder with sludge. No gallbladder wall thickening or pericholecystic fluid. No intra or extrahepatic biliary ductal dilatation. The common bile duct tapers smoothly to the level of the ampulla without evidence of choledocholithiasis or stricture.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.No definite MRI evidence of acute cholecystitis.2.No intra or extrahepatic biliary ductal dilatation.3.Multiloculated right and left pleural effusions are not significantly changed compared to 2/14/2016 CT examination. Right lower lobe opacity is again noted and may represent infection versus drug reaction.