CT - Liver protocol CT scan
Axial non-contrast
Axial C+ arterial phase
Axial C+ portal venous phase
Axial C+ delayed
There is intra- and extra-hepatic biliary tracts dilatation, with multiple intraluminal tumefactive sludge material of different sizes and densities, which showed no enhancement on dynamic imaging (judged by HU, not only visually), some of these are calcified (hepatolithiasis), being hyperdense on CT. A diverticulum-like outpouching arising from the left main intrahepatic duct is also seen, better seen on MRI. The gallbladder is enlarged containing a few small dependent gallstones.
On the CT PV images, the colon up to the level of the caecum, is of oedematous slightly hyperenhancing mucosa, with numerous abnormal mesenteric lymph nodes and fat stranding. Further workup confirmed inflammatory bowel disease.