67-year-old man with history of elevated alkaline phosphatase and white blood cell count, evaluate for cholangitis. Please note that this examination is severely limited by artifact from the dielectric effect and the lack of intravenous contrast.ABDOMEN:LIVER, BILIARY TRACT: The liver is nodular in contour with widened fissures. A punctate focus of T2 hyperintensity in segment 4A of the liver (series 5, image 30) is too small to accurately characterize but is likely benign. There is no loss of parenchymal signal with out-of-phase sequences. No intrahepatic biliary duct dilatation is identified. Small stones are seen in the gallbladder including a stone in the gallbladder neck (series 9, image 24). The common bile duct is normal in size and there is no choledocholithiasis or obstructing mass.SPLEEN: The spleen appears normal.PANCREAS: The pancreas appears normal.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple parapelvic cysts are seen in the left kidney and there are additional cortical cysts seen in the kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy noted.BOWEL, MESENTERY: Mildly dilated loops of large and small bowel are seen without transition point.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a large amount of ascites. There are moderate bilateral pleural effusions with adjacent atelectasis.
1.Examination limited by the large volume of ascites causing dielectric artifact and lack of intravenous contrast. Please consider paracentesis prior to future MR studies.2.Cirrhotic liver, however no evidence of intra or extrahepatic biliary duct dilatation.3.Mildly dilated loops of large and small bowel in a pattern suggestive of ileus.