Status post liver donor transplant 2/08 for PSC, elevated AP 483 and CA 19-9 112. Evaluate for biliary dilatation, assess hepatic vessel patency, evaluate for evidence of cholangiocarcinoma. ABDOMEN:LUNG BASES: Left lung base nodule. Prominent right cardiophrenic lymph node, unchanged.LIVER, BILIARY TRACT: Postsurgical findings of liver transplant with hepaticojejunostomy. Geographic mass-like areas of hypoenhancing T2 hypointensity and T1 hyperintensity in the posterior right hepatic lobe and caudate lobe, significantly increased in size dating back from 2/2010. These may represent perfusion abnormalities; tumor is felt to be unlikely as vessels course through these areas without attenuation or mass effect and there is no associated diffusion restriction. No signal loss on opposed phase images in these areas to suggest fat.No definite suspicious hepatic mass is identified. Hepatic arteries, portal vein, hepatic veins are patent. Diminutive left portal vein, unchanged.Mild intrahepatic biliary ductal dilatation with scattered foci of narrowing, not significantly changed.SPLEEN: Splenomegaly with prominence of the splenic vein, unchanged. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst.RETROPERITONEUM, LYMPH NODES: Prominent porta hepatis lymph nodes, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace abdominal ascites.
1.Stable mild intrahepatic biliary ductal dilatation with scattered areas of narrowing. Patent hepatic vasculature.2.Geographic areas of signal abnormality involving the right posterior hepatic lobe and caudate lobes progressively increased in size from 2010, possibly representing perfusion abnormalities. 3.No definite suspicious hepatic mass is identified.4.Left lung base nodule, for which CT chest is recommended for further evaluation.