79-year-old female with history of pancreas divisum and a pancreatic IPMN. Previous MRI/MRCP in 2013. Surveillance. ABDOMEN:LIVER, BILIARY TRACT: 11 mm non-enhancing T1 hypointense lesion in the right hepatic lobe is unchanged, only evident on T1-weighted imaging, uncertain whether artifactual or a benign lesion such as a cyst, stable from prior MRI exam. This is not seen on T2 or diffusion weighted images, may be due to slice thickness. Punctate arterially enhancing focus in hepatic segment 7, most likely a perfusional defect. Otherwise, no focal hepatic lesions.No intrahepatic biliary ductal dilation. The extrahepatic bile duct measures 8 mm, unchanged. Cholelithiasis without choledocholithiasis.SPLEEN: No significant abnormality noted.PANCREAS: Pancreas divisum is again noted, with normal pancreatic parenchymal signal. The mildly dilated main pancreatic duct measures 7 mm, unchanged, and drains via the minor papilla. The ovoid T2 hyperintense lesion in the uncinate process measures 9 x 9 mm on MRCP images, previously 8 x 7 mm, and again appears to communicate with the ventral pancreatic duct. Additional punctate T2 hyperintense foci are seen in the pancreas, likely representing sidebranch IPMNs. No solid pancreatic lesions are noted. No ampullary lesion identified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal cysts are again noted, with a hemorrhagic cyst in the left kidney upper pole.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: 2.6 cm cystic lesion in the right hemipelvis appears similar to prior, though is incompletely characterized.
1. Pancreas divisum, with unchanged mildly dilated main pancreatic duct draining via the minor papilla.2. Minimally increased size of the subcentimeter pancreatic intraductal papillary mucinous neoplasm (IPMN).