Male; 34 years old. Reason: Concern for a dominant stricture History: PSC/pruritus ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Mild periportal increased signal intensity which may represent periportal edema versus inflammation is similar to prior exam. Multifocal areas of intrahepatic biliary stricturing and associated dilatation are redemonstrated, similar to prior exam. Again, the common duct is attenuated throughout its course, including a short focal stenosis at the ampulla. A short segment stenosis just distal to the confluence of the right and left intrahepatic duct is not significantly changed. The distal right and left intrahepatic ducts are again poorly visualized proximal to Klatskin's point, similar to prior exam. No new focal mass.Geographic T2 hypointense signal and heterogenous enhancement is likely related to chronic liver disease, similar to prior exam.SPLEEN: Stable moderate splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable prominent subcentimeter in short axis perihilar lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
Multifocal intra-and extrahepatic biliary duct strictures are consistent with patient's history of primary sclerosing cholangitis and not significantly changed since prior study. No new focal mass.