81-year-old female with primary sclerosing cholangitis. Screening exam for cholangiocarcinoma and hepatocellular carcinoma. ABDOMEN:LIVER, BILIARY TRACT: Multiple biliary strictures are redemonstrated. There are strictures of the common bile duct at the level of the ampulla, the mid portion, and at Klatskin's point. A stricture of the main left hepatic duct is noted, and left-sided intrahepatic ductal dilatation has worsened in the interval. Atrophy of the left hepatic lobe is unchanged. There is a stricture at the cystic duct where it joins the common hepatic duct with distention of the gallbladder. Multiple intrahepatic strictures are again noted on the right.No obvious mass is identified, however due to technical factors the patient needs to be recalled for a repeat postcontrast exam. A mass in the left hepatic lobe cannot be excluded.SPLEEN: No significant abnormality noted.PANCREAS: Stable appearance compared to prior study with mild prominence of the duct.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Biliary strictures redemonstrated as described above. Left-sided ductal dilatation has slightly worsened since the prior 2014 MRI exam.2.No obvious mass is identified, however a mass in the left hepatic lobe cannot be excluded due to technical factors. The patient should be recalled for repeat postcontrast imaging.