Female 66 years old Reason: 66 y/o F with prior CT abd/pelvis 12/29/2014 (elsewhere) noted intra and extrahepatic biliary dilation and dilated pancreatic duct with suggestion of pancreas divisum. MRCP requested to further evaluate. The absence of intravenous contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LIVER, BILIARY TRACT: The common duct is somewhat tortuous and measures 7 mm in maximum transverse dimension, within normal limits in this patient who is postcholecystectomy. There is no focal liver lesion within the limitations of this noncontrast study.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas demonstrates normal intrinsic T1 hyperintense signal. There is a bilobed 7 mm T2 hyperintensity within the pancreatic tail which communicates with the pancreatic duct. This is consistent with a side branch IPMN. There is a 2 mm T2 hyperintensity within the body/tail downstream from this lesion and although there is no definite communication with the pancreatic duct this likely represents a second side branch IPMN. There is no pancreatic duct dilatation which measures 3 mm in maximum dimension. There is no pancreas divisum or accessory pancreatic duct.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: T2 hyperintense lesion at the lower pole of the left kidney is consistent with a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a large duodenal diverticulum.BONES, SOFT TISSUES: No significant abnormality noted.
There is no pancreas divisum or accessory pancreatic duct. Two cystic lesions within the pancreas are consistent with sidebranch IPMNs. Guideline suggestions for IPMN lesions of this category would for follow up imaging in 1 year to ensure stability.