PMC4648108_01
(A) Coronal T2 W image. The hepatic flexura and the right kidney appears below the diaphragm. No liver tissue is seen posteriorly. (B) Axial T2 W image. The hepatic flexura and the right kidney appears below the diaphragm. No liver tissue is seen posteriorly. Adrenal gland is in front of the right kidney. (C) Post-contrast T1 W axial scan. Hepatic veins are seen; the inferior vena cava is located more laterally. (D) Axial 2D fiesta T2 W image. Enlargement of the portal vein and the right and left branches are seen. The portal vein course is more vertical and lateral, showing convexity medially.
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The hepatic flexura and the right kidney were located just below the diaphragm. The right colon and hepatic flexura were displaced laterally and posteriorly. The right adrenal gland was located in front of the kidney (Figure 1A, 1B). All of the hepatic veins were normal (Figure 1C). The portal vein was found to extend laterally then curve antero-medially with an acute angulation (Figure 1D).
(A) Coronal 2D fiesta T2 W image. The course of the main bile duct and the portal vein is seen; dilated portal vein causes indentation of the common bile duct (arrow). (B) 3D MRCP image shows the common bile duct and the right and left branches. Extrinsic compression of the common bile duct caused by enlarged portal vein is seen (small arrow). High signal intensity caused by the hepatic flexura luminal content is remarked (arrow).
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The common bile duct had a more vertical course than normal (Figure 2A, 2B).