36-year-old female with facial osteomyelitis, fevers, enhancing liver lesions, and pancreatic thickening. Currently with abdominal pain, high inflammatory markers. Please perform MRI/MRCP given elevation of alkaline phosphatase and prior abnormal pancreas. ABDOMEN:LIVER, BILIARY TRACT: Mild central intrahepatic biliary ductal dilatation is noted. No discrete lesion is identified. Normal common bile duct.In hepatic segment 5, there is a 0.9 x 1.2 cm hypoenhancing lesion (axial series 13 image 164) that also demonstrates intralesional fat (axial series 1100 image 59). This lesion is faintly hypointense on the precontrast T1 fat-saturated series (axial series 11 image 59). No restricted diffusion.In hepatic segment 4B, there is 3.9 x 1.6 cm hypoenhancing lesion (axial series 13 image 186). This lesion is isointense on the T1 precontrast series. No restricted diffusion.SPLEEN: No significant abnormality noted.PANCREAS: No pancreatic ductal dilatation. No parenchymal abnormality.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.There are 2 hypoenhancing hepatic lesions. The smaller lesion in segment 5 is favored to represent an adenoma, and the larger lesion in segment IVb could represent an adenoma versus an FNH.2.Mild central intrahepatic biliary ductal dilatation. No discrete lesion is identified. Comparison with prior outside imaging would be helpful.3.No pancreatic abnormality is identified.