History of cholecystitis status post drain placement, now with altered mental status ABDOMEN:LIVER, BILIARY TRACT: Abnormal diffuse T2 hypointense signal throughout the liver, likely reflecting iron deposition. Partially imaged cholecystostomy drain. Thick-walled gallbladder containing foci of signal void consistent with cholelithiasis, small pericholecystic edema. No intrahepatic or extra hepatic biliary duct dilatation visualized.SPLEEN: Abnormal diffuse T2 hypointense signal throughout spleen, likely reflecting iron deposition.PANCREAS: Focally prominent pancreatic duct at level of head measuring up to 4 mm, however tapering suggested distally. No pancreas divisum.ADRENAL GLANDS: Stable mild adrenal thickening.KIDNEYS, URETERS: Kidneys decreased in longitudinal dimension and renal parenchyma essentially replaced by innumerable small homogeneously T2 hyperintense simple cysts as well as additional rounded lesions demonstrating low T2 signal, may reflect cyst containing proteinaceous material or hemorrhage but these are incompletely assessed on this truncated study.RETROPERITONEUM, LYMPH NODES: Aortoiliac ectasia.BOWEL, MESENTERY: No gross abnormality noted.BONES, SOFT TISSUES: Decreased T2 bone marrow signal, likely reflecting sequela of iron deposition/renal osteodystrophy, L4 compression deformity unchanged from earlier CT imaging. Scoliosis seen.OTHER: Cardiomegaly.
1. Incomplete exam secondary to patient's combative behavior and inability to follow commands. Study is also suboptimal secondary to extensive motion and respiratory artifact. Reassessment with CT imaging may be of use and should be pursued as clinically indicated. 2. Thick-walled gallbladder containing foci of signal void consistent with cholelithiasis, small pericholecystic edema, appearance consistent with patient's reported history of cholecystitis. 3. Sequela of medical renal disease including atrophic kidneys with parenchyma essentially replaced by innumerable cysts, simple as well as complex (latter incompletely assessed on this truncated study), and renal osteodystrophy, unchanged L4 compression deformity. Evidence of iron deposition as above. 