49-year-old male with history of PSC, cirrhosis, ascites. Evaluate biliary and vessel patency. HCC screening. PSC pre-OLT evaluation. Exam is limited by motion artifact.ABDOMEN:LIVER, BILIARY TRACT: The liver measures 18.5 cm in craniocaudal dimension. There is mild fissural widening. The umbilical vein is recanalized and there are mild gastroesophageal varices indicating portal hypertension. Mild upper abdominal ascites. Stable enlargement of gastrohepatic and portacaval lymph nodes.There is again heterogeneous enhancement of the liver during the arterial phase. The arterial phase on today's exam was obtained with greater delay on the prior exam and the entire portal vein is opacified. No discrete arterially enhancing lesion or lesions with washout are identified. Mild attenuation of the hepatic veins and IVC is again noted however the hepatic vasculature appears patent.MRCP images are degraded by extensive motion artifact within this limitation, there is no significant biliary ductal dilatation mild biliary irregularity is suggested centrally at the level of the confluence. No dominant stricture or enhancing lesion. Cholelithiasis within a normally distended gallbladder.SPLEEN: The spleen measures 13 cm in craniocaudal dimension.PANCREAS: No pancreatic ductal dilatation. The pancreas enhances normally.ADRENAL GLANDS: Nonspecific nodularity of the left adrenal gland is unchanged.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild gastroesophageal varices and mild upper abdominal ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Mild hepatosplenomegaly with mild ascites and stigmata of portal hypertension. No suspicious hepatic lesions are identified. Again noted is arterial phase perfusional variant of uncertain etiology, with diffuse heterogeneous enhancement of liver visualized.2.Sensitivity is limited on MRCP images due to extensive motion artifact with resultant severe image degradation. Mild biliary ductal irregularity is seen centrally at the level of the confluence. No dominant stricture or enhancing lesion delineated.