67-year-old female with history of pancreatic lesions seen on EGD/US. ABDOMEN:LIVER, BILIARY TRACT: There is mild intrahepatic biliary ductal dilatation. The common bile duct measures 9 mm. There are multiple tiny T2 hyperintense foci scattered throughout the liver which are too small to actually characterize.SPLEEN: No significant abnormality noted.PANCREAS: There is a poorly defined T2 hypointense mass arising from the pancreatic body/head junction measuring 3.0 x 1.8 cm (image 18 of series 8). There is abrupt cut off of the pancreatic duct along with distal atrophy. This lesion abuts the SMV and main portal vein. The proximal main portal vein is markedly attenuated. The splenic vein is thrombosed. There is soft tissue stranding surrounding the proximal SMA. There is hypertrophy of the common hepatic artery. The celiac trunk is not visualized.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter bilateral simple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Nonenhancing T2 hyperintense lesions located within the right aspect of the sacrum and T11 vertebral body are nonspecific.OTHER: No significant abnormality noted.
Pancreatic body mass as above with no convincing evidence of distant metastatic disease. Marked attenuation of the proximal main portal vein, splenic vein occluded. The celiac trunk is poorly visualized, most likely secondary to motion and technique. There is soft tissue stranding surrounding the SMA which may represent tumor involvement. A CTA is recommended for further evaluation of the vasculature.