Medical Imaging Report

Examination method:

CT Plain + Enhancement MPR at liver, gallbladder, pancreas, spleen and kidneysx Tongren Hospital, Capital Medical University

Image findings:

Postoperative status of hilar cholangiocarcinoma: Hilar structure is unclear and there are flakes of soft tissue density shadows at hilar which are intensified after enhancement scanning. The gallbladder is unseen. There is no obvious dilation at intra-and extra-hepatic bile duct. There are strips of soft tissue density shadows at space of subcutaneous adipose tissue of right lower abdomen.

There are quasi-circular mixed density shadows at lower edge of liver and anterior outside of right kidney, in which mainly are low density shadows and mixed with patches of high density shadows. The size is about 4.2*4.4 cm and they are not obviously intensified in enhancement scanning. Comparing with images before (CT on September 17, 2015), the peripheral patches of exudation shadows shrink.

The liver has a regular form and liver edge is smooth. Portal vein is not widened. There are multiple of low density shadows in liver with clear border and unequal in size, the largest of which locates at VIII section of right lobe of liver, about 3.8 cm * 4.6 cm * 4.3 cm in size. There are large patches of irregular low density shadows with unclear border and internal septation on the right lobe of liver, about 4.4 cm *4.9 cm * 5.8 cm in size. At arterial phase, lesion edge and septation is obviously intensified and at periphery there are patches of annular strengthening belt of higher density. At portal phase and lag phase, lesion edge and septation is intensified progressively. Peripheral annular strengthening belt is in consistence with liver parenchyma in density, with a shrinked range compared with before.

There is no abnormal density shadow at pancreas and spleen.

Bilateral kidneys have no abnormality in location and size with a regular form and a smooth edge. There are oblong-shaped low density shadows at the middle of right kidney with a clear border, about 5.9 cm *3.6 cm * 4.0 cm in size. There are strips of high density shadows and dots of low density shadows at the upper of left kidney. There is neither abnormal extension nor abnormal density shadows at bilateral pelvises. Space of peripheral fat is clear and pretrnal fascia is not thickened.

Left adrenal gland is thickened and there seems to be nodular shadows uniformly intensified.

Impression:

Comparing with images before (CT on September 17, 2015), there is no obvious change in postoperative status of hilar cholangiocarcinoma.

Comparing with before, peripheral exudation of abnormal density shadows at lower edge of the liver and anterior outside of right kidney is reduced slightly. The lesions have no change.

There are irregular low density shadows at right lobe of liver, are they cyst? or biloma combining with infection? The lesion is enlarged slightly comparing with before.

Left adrenal gland is thickened. Please refer to clinical conditions to exclude metastatic tumor.

There are strips of high density shadows at the upper of left kidney. Are they calculus? Or vascular calcification?

Report physician: x (signature)Chief approval physician: xx(signature)