46-year-old female with elevated liver enzymes and bilirubin. Status post heart transplant. Evaluate biliary/pancreatic ducts and setting of cholestasis and transaminitis. T.Bili of 1.4, AST 37, ALT, 63, Alk Phos 500. ABDOMEN:LIVER, BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation. The common bile duct measures 3.6 mm in diameter. Normal distention of the gallbladder without wall thickening or inflammatory changes. No suspicious parenchymal lesions on this noncontrast exam. Decreased T2 signal intensity of the hepatic parenchyma suggestive of iron deposition.SPLEEN: No significant abnormality noted.PANCREAS: No pancreatic ductal dilatation. No peripancreatic inflammation. There are 2 well-circumscribed subcentimeter T1 hyperintense foci anterior to the pancreatic tail (series 801 image 75), which could represent sequelae from prior pancreatitis versus small lymph. A small foci are unchanged compared to the 7/14/2014 PET/CT exam.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral punctate T2 hyperintensities are too small to characterize, favor cystic. No hydronephrosis. Trace inferior right perinephric T1 hypointense signal intensity suggestive of old hemorrhage, likely related to prior renal biopsy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Nonspecific T2 hyperintense focus of the left hemisacrum is only seen on the coronal T2 sequence (series 401 image 29) and could represent an osseous hemangioma. Susceptibility artifact from lower sternotomy wires are noted.OTHER: No significant abnormality noted.
1.No intra or extrahepatic biliary ductal dilatation. No evidence for cholecystitis.2. The T2 hypointense signal intensity of the hepatic parenchyma is suggestive of iron deposition, which could be related to prior blood transfusions.3. The subcentimeter T1 hyperintense rounded foci anterior to the pancreatic tail could represent sequelae of prior pancreatitis versus lymph nodes. In retrospect, these small foci identified on the 7/14/2014 PET/CT exam.4. Evidence of old hemorrhage inferior to the right renal pole likely related to prior biopsy.