Sunday, 27 December 2015 16:48

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Date : 00.00.00
Name of the Patient : Abc Xyzma M.U. Anlmn / F / 50 yrs.
Referred by : Dr. Abc Xyzdeo. Examination : M.R.Cholangiogram.
CLINICAL PROFILE :
C/O abdominal pain with weight loss and loss of appetite since 2 months with jaundice (detected 4 days). EXAMINATION :
MR Cholangiogram was performed. 6 mm thick T1 Weighted and T2 Weighted axial images. 5 mm thick STIR coronal images.OBSERVATION :
There are multiple, well-marginated hypointense lesions on the T1 Weighted images, of varying size, scattered in the hepatic parenchyma on either side. These lesions appears hyperintense on the T2 Weighted and STIR images. There is mild dilatation of intrahepatic biliary radicles, the left and right hepatic ducts and the common hepatic duct. The portal system is unremarkable.

There is seen an approximately 1.2 x 2.1 cms sized hypointense mass lesion on the T2 Weighted images in the region of the neck of the gall bladder. This lesion appears isointense to the rest of the gall bladder on the T1 Weighted images. Mild thickening of the gall bladder wall is noted (about 4.0 mm).
The pancreas, spleen and both kidneys are unremarkable.

There are no abnormally enlarged abdominal lymphnodes noted. There is no free fluid in the abdomen.
Scan-00005


Incidentally noted are about 1.5 cms diameter sized nodular lesions in the lower lobes of both the lungs.
The MRCP reveals mild dilatation of the intrahepatic biliary redicles, left and right hepatic ducts and the common hepatic duct and the proximal CBD. The cystic duct and the gall bladder are not well-identified. The pancreatic duct is not dilated. Distal CBD is not visualized.

IMPRESSION : An approximately 1.2 x 2.1 cms sized mass lesion in the region of the neck of the gall bladder may represent a gall bladder neoplasm. Non visualization of the cystic duct may suggests tumor infiltration. Obstruction of the proximal CBD is noted with mild dilatation of the hepatic ducts and the intrahepatic biliary radicles. Multiple focal lesions in the hepatic parenchyma and nodular lesions in the lung base most likely represent metastatic lesions.


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