Reason: Evaluate for biliary dilation; concern for ascending cholangitis History: fever, hypotension, abdominal pain and jaundice. Albumin 2.1, Bilirubin 4.2 Additional history per electronic medical record: Also history of HIV and leukemia. Evaluation is somewhat limited by lack of intravenous contrast. MRCP images are also mildly degraded by motion.ABDOMEN:LIVER, BILIARY TRACT:Liver demonstrates normal morphology. There is diffusely decreased signal on in phase images compatible with hemosiderin deposition. No focal lesions are detected within the limitations of noncontrast imaging.The gallbladder appears within normal limits without evidence of cholelithiasis or gallbladder wall thickening. There is no abnormal biliary ductal dilatation, evidence of biliary stricture, or evidence of choledocholithiasis.SPLEEN: The spleen is upper normal in size measuring up to 13.8 cm and demonstrates nonspecific somewhat heterogeneous signal including patchy areas of increased T2 signal as well as areas of decreased T1 and T2 signal (compatible with hemosiderin deposition).PANCREAS: The pancreas demonstrates normal morphology without gross masses within the limitations of noncontrast imaging. The pancreatic duct is nondilated without evidence of pancreatic duct stricture or stones. No significant peripancreatic edema or fluid collection is identified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild perinephric fluid bilaterally as well as abnormally increased DWI signal diffusely within the kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is nonspecific diffusely heterogeneous signal within the bone marrow with some areas of increased DWI signal.OTHER: No significant abnormality noted.
1.Examination mildly limited by lack of intravenous contrast and motion. Within these limitations:2.No evidence of cholecystitis, biliary ductal dilatation, or choledocholithiasis.3.Hemosiderin deposition within the liver and spleen.4.Heterogeneously increased T2 signal within the spleen which is nonspecific but may reflect infection, such as hematogenous disseminated infection including atypical etiologies.5.Heterogeneous bone marrow signal which is nonspecific but likely related to patient's leukemia.6.Mild perinephric fluid and abnormal renal signal which is nonspecific but could be related to infection, correlation with urinalysis is recommended.