Male 46 years old; Reason: new diagnosis of cirrhosis, evaluate liver morphology, veins, biliary tree and rule out PSC History: new ascites Suboptimal study secondary to artifact related to presence of patient's large ascites.ABDOMEN:LUNGS BASES: Partially imaged gynecomastia. LIVER, BILIARY TRACT: Hepatomegaly, liver measures 21 cm in craniocaudal dimension. Widening of the fissures and surface nodularity seen consistent with underlying cirrhosis. Diffuse signal loss on opposed phase imaging compared to in phase, consistent with hepatic steatosis. No suspicious arterially enhancing hepatic focus seen. Tiny nonenhancing focus at level of liver dome anteriorly on image 202 series 16 favored to be a tiny cyst with corresponding increased T2 signal suggested. Minimal biliary ductal irregularity seen centrally at level of confluence, see key image. No intrahepatic or extrahepatic biliary duct dilatation. Gallbladder contracted containing cholelithiasis. Mild gallbladder wall edema, nonspecific in setting of ascites. Patent portal veins and splenic vein, contrast noted opacifying SMV. Patent hepatic arteries and veins.SPLEEN: Spleen measures up to 13.2 cm.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Prominent upper abdominal including periportal lymph nodes, favored to be reactive in etiology.BOWEL, MESENTERY: Large ascites with associated centralization of bowel.BONES, SOFT TISSUES: Anasarca.OTHER: No significant abnormality noted.
Cirrhotic liver morphology, hepatomegaly, and diffuse hepatic steatosis. Large ascites.Minimal biliary ductal irregularity seen centrally at level of confluence, nonspecific but may be seen in PSC in appropriate clinical setting. No intrahepatic or extrahepatic biliary duct dilatation. Additional findings as above.