47-year-old female patient with question of obstructive venous thrombosis in setting of significant polycystic liver disease. Pain, early satiety. ABDOMEN:LIVER, BILIARY TRACT: The liver is enlarged, measuring 26 cm in the craniocaudal dimension, by innumerable cysts replacing a majority of the hepatic parenchyma. The largest within the right hepatic lobe measures 11 x 12 cm and demonstrates internal intermediate T1 hyperintensity likely reflecting proteinaceous material or blood products. No suspicious arterial enhancing component is identified. Furthermore, there are additional small cystic foci within the liver compatible with peribiliary cysts. There is diffuse mild intrahepatic biliary ductal dilatation. The common bile duct is nondilated. The gallbladder is unremarkable.The central hepatic venous vasculature appears patent, however, is poorly delineated peripherally secondary to the multiple hepatic lesions. A large hepatic cyst additionally compresses the IVC and the portal vein at it enters the hilum. The azygous vein is prominent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts with a few cysts containing layer T1 hyperintensity compatible with blood products. Additional subcentimeter T2 hypointense and T1 hyperintense lesions likely represent hemorrhagic cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Enlarged multicystic liver compatible with diagnosis of polycystic liver disease.2.Poorly delineated hepatic vasculature peripherally secondary to the numerous cysts with compression of the IVC and portal vein from a dominant cyst.3.Diffuse mild intrahepatic biliary ductal dilatation. 