Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The Following Abdominal CT Report Indicate?
Question: can you please put this into perspective for me?
Narrative
CT abdomen and pelvis with IV contrast
Comparison: None available.
56 year old male
Indication: ABDOMINAL PAIN, RUQ mass, R19.01 Right upper quadrant
abdominal swelling, mass and lump.
Technique: CT imaging was performed of the abdomen and pelvis following
the uncomplicated administration of intravenous contrast (Isovue-300, 150
mL at 3 mL/sec). Iodinated contrast was used due to the indications for
the examination, to improve disease detection and further define anatomy.
The most recent serum creatinine is 1.0 mg/dL. Coronal reformatted images
were generated and reviewed.
Findings:
There are no suspicious pulmonary nodules or focal airspace consolidation.
The heart is normal in size. No significant pleural or pericardial
effusion. Small hiatal hernia. Fluid noted extending to the diaphragmatic
hiatus.
There is diffuse hepatic steatosis and hepatomegaly. The gallbladder is
decompressed. Hepatic and portal veins are patent. Pancreas demonstrates no
evidence of focal mass or ductal dilation. Fluid and fat stranding is not
centered around the pancreas. Small duodenal diverticulum noted. The spleen
is enlarged measuring up to 18 cm. No evidence of adrenal nodule. There is
no hydronephrosis. Scattered subcentimeter retroperitoneal and mesenteric
lymph nodes noted in the upper abdomen. There is stranding surrounding the
origin of the celiac and superior mesenteric arteries. Small volume
perihepatic ascites with extension into the pelvis. No evidence of free
intraperitoneal gas.
There is diffuse colonic diverticulosis without evidence of acute
diverticulitis. Normal caliber appendix in the right lower quadrant. There
is scattered calcified atherosclerosis in the abdominal aorta and its
branches. Urinary bladder is decompressed and not well-visualized. There
are no acute fractures or bony destructive lesions.
Impression:
1. Diffuse hepatic steatosis and hepatomegaly with associated splenomegaly
and small volume perihepatic ascites. Findings suspicious for
cirrhosis/chronic liver disease. No evidence of focal hepatic mass on this
single phase examination.
2. Decompressed gallbladder without significant wall thickening.
Narrative
CT abdomen and pelvis with IV contrast
Comparison: None available.
56 year old male
Indication: ABDOMINAL PAIN, RUQ mass, R19.01 Right upper quadrant
abdominal swelling, mass and lump.
Technique: CT imaging was performed of the abdomen and pelvis following
the uncomplicated administration of intravenous contrast (Isovue-300, 150
mL at 3 mL/sec). Iodinated contrast was used due to the indications for
the examination, to improve disease detection and further define anatomy.
The most recent serum creatinine is 1.0 mg/dL. Coronal reformatted images
were generated and reviewed.
Findings:
There are no suspicious pulmonary nodules or focal airspace consolidation.
The heart is normal in size. No significant pleural or pericardial
effusion. Small hiatal hernia. Fluid noted extending to the diaphragmatic
hiatus.
There is diffuse hepatic steatosis and hepatomegaly. The gallbladder is
decompressed. Hepatic and portal veins are patent. Pancreas demonstrates no
evidence of focal mass or ductal dilation. Fluid and fat stranding is not
centered around the pancreas. Small duodenal diverticulum noted. The spleen
is enlarged measuring up to 18 cm. No evidence of adrenal nodule. There is
no hydronephrosis. Scattered subcentimeter retroperitoneal and mesenteric
lymph nodes noted in the upper abdomen. There is stranding surrounding the
origin of the celiac and superior mesenteric arteries. Small volume
perihepatic ascites with extension into the pelvis. No evidence of free
intraperitoneal gas.
There is diffuse colonic diverticulosis without evidence of acute
diverticulitis. Normal caliber appendix in the right lower quadrant. There
is scattered calcified atherosclerosis in the abdominal aorta and its
branches. Urinary bladder is decompressed and not well-visualized. There
are no acute fractures or bony destructive lesions.
Impression:
1. Diffuse hepatic steatosis and hepatomegaly with associated splenomegaly
and small volume perihepatic ascites. Findings suspicious for
cirrhosis/chronic liver disease. No evidence of focal hepatic mass on this
single phase examination.
2. Decompressed gallbladder without significant wall thickening.
Brief Answer:
fatty build up in the liver with reduced liver function
Detailed Answer:
HI, thanks for using healthcare magic
The technique aspect of the report only indicated how the imaging was done , the areas that were looked at, also mentioned that it used contrast (fluid ) to highlight different areas.
The next part of the report mentions the findings and the last part is a summary of these findings.
These aspects indicate that there is : (1) build up of fat in the liver (hepatic steatosis). This can be due to the use of alcohol or related to diet/inactivity/illness such as diabetes , high cholesterol.
Where it is not related to alcohol use, it is called non alcoholic fatty liver disease.
Both alcohol liver disease and non alcohol disease can go on to cause cirrhosis which means that there is now scarring going on in the liver.
Cirrhosis was mentioned in the summary.
Chronic liver disease means that these changes were likely present for a long time.
Decreased function of the liver can cause the build up of fluid (ascites). This is the reason for the perihepatic ascites (fluid) mentioned.
Enlargement of the liver or poor function of the liver can be associated with changes in the spleen because the blood supply is connected. This is the reason for the spleen changes.
There is no evidence of a mass/ growth in the liver
(2)decompressed gallbladder means that there is shrinkage of the gallbladder which is commonly due to either an acute (immediate, happening at the moment) or chronic (long term) infection of the gall bladder
The gallbladder and liver are also linked, the gallbladder lies just behind the liver and they are connected by ducts/passage ways.
In summary: (1) there are long term changes to the liver, fatty build up causing inflammation and scarring. No mass/cancer seen
Treatment would involve looking at the cause. If there is a history of alcohol use, this would need to be discontinued.
If the liver changes are related to diet/inactivity etc then lifestyle changes of these would be needed eg healthy diet, increased activity, control of cholesterol , diabetes
Avoid any medications that may affect the liver
Medications such as statins , may be needed though liver blood test would needed to monitor
Zinc replacement is sometimes suggested
I hope this helps, feel free to ask any other questions
fatty build up in the liver with reduced liver function
Detailed Answer:
HI, thanks for using healthcare magic
The technique aspect of the report only indicated how the imaging was done , the areas that were looked at, also mentioned that it used contrast (fluid ) to highlight different areas.
The next part of the report mentions the findings and the last part is a summary of these findings.
These aspects indicate that there is : (1) build up of fat in the liver (hepatic steatosis). This can be due to the use of alcohol or related to diet/inactivity/illness such as diabetes , high cholesterol.
Where it is not related to alcohol use, it is called non alcoholic fatty liver disease.
Both alcohol liver disease and non alcohol disease can go on to cause cirrhosis which means that there is now scarring going on in the liver.
Cirrhosis was mentioned in the summary.
Chronic liver disease means that these changes were likely present for a long time.
Decreased function of the liver can cause the build up of fluid (ascites). This is the reason for the perihepatic ascites (fluid) mentioned.
Enlargement of the liver or poor function of the liver can be associated with changes in the spleen because the blood supply is connected. This is the reason for the spleen changes.
There is no evidence of a mass/ growth in the liver
(2)decompressed gallbladder means that there is shrinkage of the gallbladder which is commonly due to either an acute (immediate, happening at the moment) or chronic (long term) infection of the gall bladder
The gallbladder and liver are also linked, the gallbladder lies just behind the liver and they are connected by ducts/passage ways.
In summary: (1) there are long term changes to the liver, fatty build up causing inflammation and scarring. No mass/cancer seen
Treatment would involve looking at the cause. If there is a history of alcohol use, this would need to be discontinued.
If the liver changes are related to diet/inactivity etc then lifestyle changes of these would be needed eg healthy diet, increased activity, control of cholesterol , diabetes
Avoid any medications that may affect the liver
Medications such as statins , may be needed though liver blood test would needed to monitor
Zinc replacement is sometimes suggested
I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I really appreciate your response and having blood test and physical on Monday.
All this scares me however does it appear that I am in immediate danger as I feel great.
I am starting a diet and exercise regimen today as I am about 70 pounds overweight and haven't exercised on a regular basis.
Would blood pressure meds or pre diabetes meds have some affect on this diagnosis?
Any further information would be appreciated as I am a little rattled after getting this information this am.
Thank you.
All this scares me however does it appear that I am in immediate danger as I feel great.
I am starting a diet and exercise regimen today as I am about 70 pounds overweight and haven't exercised on a regular basis.
Would blood pressure meds or pre diabetes meds have some affect on this diagnosis?
Any further information would be appreciated as I am a little rattled after getting this information this am.
Thank you.
Brief Answer:
very good, you are on the right track
Detailed Answer:
HI
It is understandable to be rattled but you are already on the right track.
Change in diet and exercise is a very good way to start, that's great. It would reduce further damage to the liver.
Definitely control risk factors such as prediabetes, diabetes , high cholesterol or high blood pressure. Control of these, if present would also safeguard the liver.
The point is to be proactive and you are already doing that by your lifestyle changes.
The blood tests would likely to include liver function tests and proteins if these have not been done recently
If you have any other queries, can let me know
very good, you are on the right track
Detailed Answer:
HI
It is understandable to be rattled but you are already on the right track.
Change in diet and exercise is a very good way to start, that's great. It would reduce further damage to the liver.
Definitely control risk factors such as prediabetes, diabetes , high cholesterol or high blood pressure. Control of these, if present would also safeguard the liver.
The point is to be proactive and you are already doing that by your lifestyle changes.
The blood tests would likely to include liver function tests and proteins if these have not been done recently
If you have any other queries, can let me know
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Can you help me understand the significance of the "HIGH" lab results below?
Name: XXXX
Age: 56
Gender: Male
Results
Order: ASM (anti smooth muscle antibody) (86255)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Cytoplasmic (C-ANCA) 4/8/2017 <1:20 titer Neg:<1:20 Triangle Gastroenterology
Perinuclear (P-ANCA) 4/8/2017 <1:20 titer Neg:<1:20 Triangle Gastroenterology
Notes:
The presence of positive fluorescence exhibiting P-ANCA or C-ANCA patterns alone is not specific for the diagnosis of Wegener's Granulomatosis (WG) or microscopic polyangiitis. Decisions about treatment should not be based solely on XXXXXXX IFA results. The International XXXXXXX Group Consensus recommends follow up testing of positive sera with both PR- 3 and MPO-ANCA enzyme immunoassays. As many as 5% serum samples are positive only by EIA. Ref. AM J Clin Pathol 1999;111:507-513.
Atypical pANCA 4/8/2017 <1:20 titer Neg:<1:20 Triangle Gastroenterology
Notes:
The atypical pANCA pattern has been observed in a significant percentage of patients with ulcerative colitis, primary sclerosing cholangitis and autoimmune hepatitis.
Order: ceruloplasmin(82390)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Ceruloplasmin 4/8/2017 36.80 mg/dL 16.0-31.0 Triangle Gastroenterology
Order: alpha-1 antitrypsin-total (82103)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Alpha-1-Antitrypsin, Serum 4/8/2017 245.00 mg/dL 90-200 Triangle Gastroenterology
Order: TIBC (83550)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Iron Bind.Cap.(TIBC) 4/8/2017 378.00 ug/dL 250-450 Triangle Gastroenterology
UIBC 4/8/2017 305.00 ug/dL 111-343 Triangle Gastroenterology
Iron, Serum 4/8/2017 73.00 ug/dL 38-169 Triangle Gastroenterology
Iron Saturation 4/8/2017 19.00 % 15-55 Triangle Gastroenterology
Order: ferritin (82728)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Ferritin, Serum 4/8/2017 63.00 ng/mL 30-400 Triangle Gastroenterology
Order: MItochondrial Ab (83516)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Mitochondrial (M2) Antibody 4/8/2017 21.40 Units 0.0-20.0 Triangle Gastroenterology
Notes:
Negative 0.0 - 20.0 Equivocal 20.1 - 24.9 Positive >24.9 . Mitochondrial (M2) Antibodies are found in 90-96% of patients with primary biliary cirrhosis.
Order: ANA (antinuclear antibody) (86038)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
ANA Direct 4/8/2017 Negative Negative Triangle Gastroenterology
Name: XXXX
Age: 56
Gender: Male
Results
Order: ASM (anti smooth muscle antibody) (86255)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Cytoplasmic (C-ANCA) 4/8/2017 <1:20 titer Neg:<1:20 Triangle Gastroenterology
Perinuclear (P-ANCA) 4/8/2017 <1:20 titer Neg:<1:20 Triangle Gastroenterology
Notes:
The presence of positive fluorescence exhibiting P-ANCA or C-ANCA patterns alone is not specific for the diagnosis of Wegener's Granulomatosis (WG) or microscopic polyangiitis. Decisions about treatment should not be based solely on XXXXXXX IFA results. The International XXXXXXX Group Consensus recommends follow up testing of positive sera with both PR- 3 and MPO-ANCA enzyme immunoassays. As many as 5% serum samples are positive only by EIA. Ref. AM J Clin Pathol 1999;111:507-513.
Atypical pANCA 4/8/2017 <1:20 titer Neg:<1:20 Triangle Gastroenterology
Notes:
The atypical pANCA pattern has been observed in a significant percentage of patients with ulcerative colitis, primary sclerosing cholangitis and autoimmune hepatitis.
Order: ceruloplasmin(82390)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Ceruloplasmin 4/8/2017 36.80 mg/dL 16.0-31.0 Triangle Gastroenterology
Order: alpha-1 antitrypsin-total (82103)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Alpha-1-Antitrypsin, Serum 4/8/2017 245.00 mg/dL 90-200 Triangle Gastroenterology
Order: TIBC (83550)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Iron Bind.Cap.(TIBC) 4/8/2017 378.00 ug/dL 250-450 Triangle Gastroenterology
UIBC 4/8/2017 305.00 ug/dL 111-343 Triangle Gastroenterology
Iron, Serum 4/8/2017 73.00 ug/dL 38-169 Triangle Gastroenterology
Iron Saturation 4/8/2017 19.00 % 15-55 Triangle Gastroenterology
Order: ferritin (82728)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Ferritin, Serum 4/8/2017 63.00 ng/mL 30-400 Triangle Gastroenterology
Order: MItochondrial Ab (83516)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
Mitochondrial (M2) Antibody 4/8/2017 21.40 Units 0.0-20.0 Triangle Gastroenterology
Notes:
Negative 0.0 - 20.0 Equivocal 20.1 - 24.9 Positive >24.9 . Mitochondrial (M2) Antibodies are found in 90-96% of patients with primary biliary cirrhosis.
Order: ANA (antinuclear antibody) (86038)
Notes:
PATIENT NOT FASTING PERFORMED BY: BN LabCorp Burlington 1447 York Court Burlington NC 0000 0000
Name Date Value Units Range Source
ANA Direct 4/8/2017 Negative Negative Triangle Gastroenterology
Brief Answer:
will explain for you
Detailed Answer:
HI
(1) ANCA- XXXXXXX are a type of antibodies (substances that fight against different areas of the body, also fight in some types of infection).
C-ANCA is often used in the initial assessment and follow up of a condition commonly known as wegener's granulomatosis (name recently changed). In this condition there is inflammation and destruction of some of the blood vessels in the body
P-ANCA-may be used to diagnose different types of vasculitis (inflammation of blood vessels)
Your results are negative for both of these
(2)Cerruloplasmin- this is a protein that carries copper in the blood. It also plays a role in iron use in the body (helps with iron absorption).
It also 'reacts/increases' to infection, inflammation or tissue damage.
Your increased value may be related to inflammation in the body
(3)alpha 1 anti trypsin also has different roles including that of an acute phase reactant like cerruloplasmin. This means that it also 'reacts/increases' in response to inflammation or injury.
The increase in both the alpha 1 anti trypsin and cerruloplasmin maybe due to some source of inflammation in the body.
(4)TIBC, serum ferritin, iron are all normal
(5)mitochondrial AB- is a test looking for antibodies (agents that fight against different parts of the body).
This particular test is usually looking for primary bilary cirrhosis , a disease of the bile ducts (passages that carry bile)
Your test is negative
(6)ANA is also negative, this looks for conditions such as lupus or RA and similar conditions
Please feel free to ask any other conditions
will explain for you
Detailed Answer:
HI
(1) ANCA- XXXXXXX are a type of antibodies (substances that fight against different areas of the body, also fight in some types of infection).
C-ANCA is often used in the initial assessment and follow up of a condition commonly known as wegener's granulomatosis (name recently changed). In this condition there is inflammation and destruction of some of the blood vessels in the body
P-ANCA-may be used to diagnose different types of vasculitis (inflammation of blood vessels)
Your results are negative for both of these
(2)Cerruloplasmin- this is a protein that carries copper in the blood. It also plays a role in iron use in the body (helps with iron absorption).
It also 'reacts/increases' to infection, inflammation or tissue damage.
Your increased value may be related to inflammation in the body
(3)alpha 1 anti trypsin also has different roles including that of an acute phase reactant like cerruloplasmin. This means that it also 'reacts/increases' in response to inflammation or injury.
The increase in both the alpha 1 anti trypsin and cerruloplasmin maybe due to some source of inflammation in the body.
(4)TIBC, serum ferritin, iron are all normal
(5)mitochondrial AB- is a test looking for antibodies (agents that fight against different parts of the body).
This particular test is usually looking for primary bilary cirrhosis , a disease of the bile ducts (passages that carry bile)
Your test is negative
(6)ANA is also negative, this looks for conditions such as lupus or RA and similar conditions
Please feel free to ask any other conditions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is there any immediate danger with the levels that were high or anything I can do to help lower this?
I have lost 13 LBs since we last chatted.
p.s.
I guess I am more concerned about the ones that indicated HIGH and need more specific information on those.
Ceruloplasmin 36.8mg/dl
Alpha 1- Antitrysin 245mg/dl
Mltochondrial Ab 21.4 units
Can you help with more specific explation of those and the seriousness and what I need to do to correct.
Thanks
I have lost 13 LBs since we last chatted.
p.s.
I guess I am more concerned about the ones that indicated HIGH and need more specific information on those.
Ceruloplasmin 36.8mg/dl
Alpha 1- Antitrysin 245mg/dl
Mltochondrial Ab 21.4 units
Can you help with more specific explation of those and the seriousness and what I need to do to correct.
Thanks
Brief Answer:
indicates that there is a source of inflammation
Detailed Answer:
Hi
The mitochondrial AB result was 21.4, according to the this lab , negative is less than 20, positive is greater than 24.9.
In between is equivocal, neither here or there, cannot give a definite answer/borderline. May need repeating at a later date
Alpha 1 anti trypsin and cerruloplasmin are increased. They can go up if there is any inflammation in the body.
Inflammation can occur due to infection, liver damage, trauma, autoimmune diseases such as lupus/RA etc
The source of inflammation would need to be determined
indicates that there is a source of inflammation
Detailed Answer:
Hi
The mitochondrial AB result was 21.4, according to the this lab , negative is less than 20, positive is greater than 24.9.
In between is equivocal, neither here or there, cannot give a definite answer/borderline. May need repeating at a later date
Alpha 1 anti trypsin and cerruloplasmin are increased. They can go up if there is any inflammation in the body.
Inflammation can occur due to infection, liver damage, trauma, autoimmune diseases such as lupus/RA etc
The source of inflammation would need to be determined
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What if it is the Liver Fatty tissue indicated in the earlier reports?
Brief Answer:
would only confirm that the fat build up is causing liver inflammation
Detailed Answer:
hi
liver inflammation/damage is mentioned as one of the possible sources of increased levels of these substances.
Fatty liver (fat build up), can cause the liver to become inflamed.
As mentioned earlier, this is most due to either alcohol over use or NON alcoholic fatty liver (diet, decreased activity, diseases such as diabetes causing build up of fat)
It only confirms that there is inflammation of the liver, if this is the cause. Liver function blood tests would show how the liver is working.
You have already started lifestyle changes to help with the fatty liver build up , if you can continue these , that would help a lot.
would only confirm that the fat build up is causing liver inflammation
Detailed Answer:
hi
liver inflammation/damage is mentioned as one of the possible sources of increased levels of these substances.
Fatty liver (fat build up), can cause the liver to become inflamed.
As mentioned earlier, this is most due to either alcohol over use or NON alcoholic fatty liver (diet, decreased activity, diseases such as diabetes causing build up of fat)
It only confirms that there is inflammation of the liver, if this is the cause. Liver function blood tests would show how the liver is working.
You have already started lifestyle changes to help with the fatty liver build up , if you can continue these , that would help a lot.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
