52-year-old male with resected pancreatic cancer with portacaval lymphadenopathy status post radiation therapy. Patient now with rising CA 19-9. Evaluate for interval change in nodes or presence of hepatic disease. ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. No suspicious focal hepatic enhancing lesions. Intact hepaticojejunostomy without evidence of biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Post surgical changes from prior Whipple. The gastrointestinal tract otherwise appears normal. No free mesenteric fluid or masses.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild T2 perinephric hyperintensity consistent with nonspecific inflammatory changes, unchanged compared to the previous CT examination.RETROPERITONEUM, LYMPH NODES: Reference portacaval node is unchanged and measures 1.7 x 0.8 cm (series 8, image 30). There is an additional periaortic lymph node which measures 2.4 x 1.5 cm (series 12, image 59). This node has not significantly changed in size compared to the recent CT examination; however, this node is more prominent on the current examination and demonstrates contrast enhancement.BOWEL, MESENTERY: Postsurgical changes from multiple procedure.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable portacaval and preaortic lymph node. While the preaortic lymph node has not significantly changed in size, it is more prominent on this current MRI examination and demonstrates contrast enhancement.2.No suspicious hepatic lesions.