65-year-old female with cholelithiasis and LFT elevation. Concern for CBD stone. ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis.The gallbladder is distended with T1 hyperintense biliary sludge and large intraluminal stones. No significant wall thickening. No pericholecystic fluid. Focal T2 hyperintense appearance of the gallbladder wall most compatible with adenomyomatosis (coronal series 4 image 32). There is mild dilatation of the common bile duct measuring 8 mm in diameter (axial series 5 image 32) with smooth tapering at the ampulla (series 11 image 43). Punctate central intraluminal hypointense signal (axial series 5 image 33) is only seen on the axial view and linear appearance, and flow related artifact is favored. No discrete intraluminal stones are identified. No intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Normal right adrenal gland. A small left left adrenal nodule with loss of signal intensity on out of phase imaging consistent with a lipid rich adenoma.KIDNEYS, URETERS: Subcentimeter right renal cyst. No hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Uterine fibroids (coronal series 4 images 16, 19).
1.Mild dilatation of the common bile duct without evidence of intraluminal stones. No intrahepatic biliary ductal dilatation. Hepatic steatosis.2.Cholelithiasis without convincing evidence for acute cholecystitis.3.Finding consistent with a benign lipid rich adenoma of the left adrenal gland.