41-year-old female patient with cirrhosis, hemosiderosis, hepatolithiasis status post biliary drain. HCC screening. ABDOMEN:LIVER, BILIARY TRACT: Post-surgical findings of a hepaticojejunostomy and cholecystectomy. A percutaneous biliary drain enters the left hepatic lobe biliary system and terminates in the jejunum. Moderate left hepatic lobe central biliary ductal dilatation extending to the hilum is similar to the prior exam. There is a geometric configuration of foci of signal void with corresponding T1 hyperintensity in the biliary ducts of the left hepatic lobe, which is suspicious for stones; these appear similar to the prior study. There is only mild upstream biliary ductal dilatation, unchanged from earlier exam. Intermediate signal around the biliary catheter may represent debris.There is reticular T2 hyperintensity in the right hepatic lobe consistent with fibrosis. Diffusely decreased T2 signal in the liver with paradoxical shift on in/out of phase images is compatible with iron deposition. Of note, the arterial phase images are suboptimal due to timing. Two ill-defined non-enhancing T2 hypointense hepatic lesions with signal dropout on in phase images are consistent with siderotic nodules, appearing similar to the prior study. A reference segment 7 lesion measures 1.5 x 1.3 cm (image 46, series 9), unchanged. A previously noted nodule within the inferior right hepatic lobe is not well seen on today's examination, which may be technical. No new suspicious hepatic lesion is identified.Portal vein and hepatic veins are patent.SPLEEN: Autoinfarcted spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild T2 hypointensity within the renal cortex bilaterally is suggestive of iron deposition given clinical setting of sickle cell disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large stool burden.BONES, SOFT TISSUES: Partially imaged fluid containing ventral wall abdominal hernia.OTHER: No significant abnormality noted.
1.Stable hepatic lesions compatible with siderotic nodules. No new suspicious hepatic lesion is identified. 2.Dilated central left intrahepatic ducts with multiple stones, appearing similar to the prior study.