82-year-old female patient with nausea, anorexia, failure to thrive. Question of cholangitis, hepatic parenchymal infection following findings seen on recent CT. ABDOMEN:LIVER, BILIARY TRACT: Redemonstration of patchy areas of peripheral T2 hyperintensity with diffusion abnormality within the anterior right and left hepatic lobes, similar to the most recent CT and subtly present on prior MRI; this likely represent cholangitis. No fluid collection or abscess is identified. The hepatic vasculature is patent. There is intra- and extrahepatic biliary ductal dilatation. While pneumobilia limits evaluation of the biliary system, there does appear to be a focus of signal void within fluid in the non-dependent portion of the common bile duct at the level of the ampulla (image 33, series 6). This is suspected to represent a stone, possibly measuring up to 4 mm. SPLEEN: There is an accessory splenule.PANCREAS: The main pancreatic duct is non-dilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There are multiple bilateral renal cysts, some of which are complicated. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted.
1.Within limitations of pneumobilia affecting assessment of the biliary system, suspected stone within the common bile duct at the level of the ampulla. 2.Intra- and extrahepatic biliary ductal dilatation with peripheral regions of signal abnormality within the liver favored to represent cholangitis given patient's clinical course.Findings communicated via telephone to J. Abimansour at 1646 hrs on 9/8/2016.