60-year-old male with alcoholic cirrhosis. Recent ultrasound showed possible pancreatic mass. Evaluate pancreas and liver. Pre and postcontrast T1 images are limited by motion artifact.ABDOMEN:LIVER, BILIARY TRACT: Nodular liver contour with widened fissures. Moderate abdominal ascites.There are a few scattered subcentimeter T2 hyperintense, circumscribed, nonenhancing lesions consistent with simple cysts. No suspicious liver lesion.Distended gallbladder with no cholelithiasis. There is intrahepatic and extrahepatic biliary ductal dilatation. The common duct is diffusely dilated up to 14 mm and contains multiple filling defects and layering sludge.SPLEEN: The spleen measures 14 cm in length.PANCREAS: The pancreatic parenchyma enhances normally. There is no evidence of pancreatic mass or pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a 3.1 cm T2 hyperintense, circumscribed, nonenhancing left upper pole renal lesion consistent with a cyst. There is a circumscribed, nonenhancing 1.9 cm T2 hypointense, mildly intrinsically T1 hyperintense lesion in the lower pole of left kidney. There are limitations in postcontrast imaging however this lesion does not appear to enhance and is favored to represent a proteinaceous/hemorrhagic cyst however follow-up with CT is recommended to ensure stability.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small left and trace right pleural effusion.
1.Choledocholithiasis with moderate intra and extrahepatic biliary ductal dilatation.2.Cirrhotic liver morphology with moderate ascites.3.Left inferior renal lesion is favored to represent a proteinaceous/hemorrhagic cyst. However, given the limitations and postcontrast imaging, follow-up CT in 6 months is recommended to ensure stability.