Evaluate for biliary obstruction, history of sickle cell disease Suboptimal study secondary to patient motion artifact/patient's difficulty holding his breath. ABDOMEN:LIVER, BILIARY TRACT: Markedly T2 weighted hypointense signal involving liver, spleen and bone marrow, appearance compatible with severe iron deposition/hemosiderosis as a result of patient's sickle cell disease/multiple blood transfusions. Similar findings seen to a mildly lesser extent in the pancreas. Micronodular liver contour suggestive of underlying cirrhosis. No biliary ductal dilatation delineated. Status post cholecystectomy.SPLEEN: Small dark signal spleen, related to patient's known history of sickle cell disease.PANCREAS: Markedly T2 weighted hypointense signal involving liver, spleen and bone marrow, appearance compatible with severe iron deposition/hemosiderosis as a result of patient's sickle cell disease/multiple blood transfusions. Similar findings seen to a mildly lesser extent in the pancreas. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small kidneys (right kidney measures 7 cm, while left kidney measures 5.6 cm in longitudinal dimension) that are replaced by innumerable small cysts, measuring up to 1.4 cm.RETROPERITONEUM, LYMPH NODES: IVC filter incompletely seen.BONES, SOFT TISSUES: Markedly T2 weighted hypointense signal of bone marrow, reflecting sequela of iron deposition disease. OTHER: Incompletely imaged large left retroperitoneal hematoma, involving left psoas muscle and seen in posterior pararenal space; on transaxial imaging, measures approximately 8 0.1 x 3.7 cm. Mild to moderate cardiomegaly. Patchy bibasilar airspace disease. Anasarca.
1. Suboptimal study due to patient motion artifact.2. No biliary duct dilatation.3. Findings compatible with severe iron deposition disease as above, micronodular liver contour suggestive of underlying cirrhosis. Additionally, diffuse abnormal signal of pancreas alluded to above may be seen in setting of primary hemochromatosis, correlation with patient's clinical history recommended; alternatively, may represent an additional site of severe iron deposition disease. 4. Large left-sided retroperitoneal hematoma partially imaged. 5. Patchy bibasilar pulmonary airspace disease.Findings discussed with fellow Dr. E. Coronel at 12 p.m. on 2/22/15.