81-year-old man status post Whipple 9/2016 for ampullary adenocarcinoma, now with recurrent pancreatitis and abdominal pain. ABDOMEN:LIVER, BILIARY TRACT: Round foci of diffusion restriction, mild T2 hyperintensity, and peripheral enhancement are seen in segments 4A and 6. The segment 4 lesion (1101/235) measures 10 x 9 mm and the segment 6 lesion (1101/270) measures 12 x 8 mm. The liver is otherwise normal in signal and morphology.There is no significant intra or extrahepatic biliary ductal dilatation. The portal vein is patent.SPLEEN: No significant abnormality noted.PANCREAS: Patient status post resection of the pancreatic head. There is vague, geographic diffusion restriction at the pancreatic anastomosis (506/184) without a corresponding abnormality on T1 or T2 weighted images to suggest a lesion. The pancreatic duct is mildly prominent.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple renal cysts noted. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Scattered subcentimeter retroperitoneal and peripancreatic lymph nodes are noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Segment 4A and 6 hepatic lesions highly suspicious for metastases.2.Nonspecific diffusion restriction near the pancreatic anastomosis without discrete lesion identified on T1 or T2-weighted images, possibly related to inflammation.