Markedly elevated alkaline phosphatase. Hepatic MRI inconclusive. History of known ulcerative colitis with new onset pruritis and elevated alkaline phosphatase. Evaluate for PSC versus extrinsic biliary compression. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, signal intensity and size. No focal suspicious lesion.The common hepatic duct measures up to 7 mm. There is irregular dilatation and narrowing of the intrahepatic and extrahepatic bile ducts most noticeably of the left hepatic duct (series 5 image 1).No filling defect in the common bile duct is identified. The common bile duct tapers gradually towards the ampulla without a discrete mass lesion.. 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.
Irregular narrowing and dilatation of the intrahepatic and extrahepatic bile ducts compatible with PSC without a discrete mass lesion.