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Abdominal Manifestations of Cystic Fibrosis in Older Children and Adults

Tanya M. Fields1, Steven J. Michel1,2, Carina L. Butler1, Vesna M. Kriss1 and Sheri L. Albers1

1 Department of Diagnostic Radiology, University of Kentucky, 800 Rose St., HX-311, Lexington, KY 40536.
2 Present address: Northwest Radiologists, Inc., Bellingham, WA 98225.


Figure 1
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  		Fig. 1 —24-year-old woman with cystic fibrosis. Abdominal contrast-enhanced CT scan reveals marked pancreatic glandular atrophy, which is nearly replaced by fat (arrows). Also note hepatomegaly (H).

 

Figure 2
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  		Fig. 2 —18-year-old woman with cystic fibrosis. Axial T1-weighted image without fat saturation through abdomen shows markedly increased signal in region of pancreas (arrows), which is consistent with near-complete fatty replacement.

 

Figure 3
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  		Fig. 3 —20-year-old woman with cystic fibrosis. Contrast-enhanced CT scan of abdomen reveals discrete high-density foci in pancreas (arrow) that are consistent with multiple tiny pancreatic calcifications.

 

Figure 4
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  		Fig. 4 —19-year-old woman with cystic fibrosis. Contrast-enhanced abdominal CT scan, including magnification view, shows near-complete replacement of pancreas by multiple low-attenuation masses (long thin arrows), which is consistent with pancreatic cystosis. Incidentally noted are pancreatic calcifications (short thin arrow) and colonic wall thickening (thick arrow).

 

Figure 5
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  		Fig. 5 —19-year-old woman with cystic fibrosis. Transverse sonogram through abdomen identifies increased echogenicity of hepatic parenchyma (L) compared with kidney (K), which is consistent with fatty liver infiltration. Note portal triads are difficult to discern.

 

Figure 6
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  		Fig. 6 —15-year-old girl with cystic fibrosis. Contrast-enhanced abdominal CT scan identifies atrophied, cirrhotic liver (L), splenomegaly (S), abundant ascites (thick arrow), and venous collaterals (thin arrows). These findings are consistent with portal hypertension.

 

Figure 7
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  		Fig. 7 —29-year-old woman with cystic fibrosis. Transverse sonographic view of gallbladder reveals multiple echogenic structures in gallbladder and posterior wall shadowing (arrows), which is consistent with cholelithiasis.

 

Figure 8
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  		Fig. 8 —25-year-old woman with cystic fibrosis. Contrast-enhanced abdominal CT image shows microgallbladder (thin arrow). Incidentally noted is pancreatic fatty replacement (thick arrow).

 

Figure 9
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  		Fig. 9 —17-year-old girl with cystic fibrosis. Coronal T2-weighted MR cholangiopancreatograms reveal microgallbladder (thin arrows). Two fluid collections are noted in region of pancreas (thick arrows) and represent pancreatic pseudocysts. Arrowhead indicates cystic duct.

 

Figure 10
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  		Fig. 10 —15-year-old boy with cystic fibrosis. Contrast-enhanced abdominal CT scan identifies focal biliary dilatation in right lobe of liver (arrows). Also of note is cirrhotic liver (L) with associated ascites (A).

 

Figure 11
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  		Fig. 11 —18-year-old woman with cystic fibrosis. Contrast-enhanced abdominal CT scan identifies multiple loops of dilated small bowel (arrows), which is consistent with distal intestinal obstruction syndrome.

 

Figure 12
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  		Fig. 12 —29-year-old woman with cystic fibrosis. Contrast-enhanced abdominal CT image reveals cecal wall thickening (arrow) and pericolonic fat stranding (arrowhead), which are consistent with additional manifestation of distal intestinal obstruction syndrome.

 

Figure 13
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  		Fig. 13 —18-year-old woman with cystic fibrosis. Axial unenhanced pelvic CT scan with coronal reformatted image (inset) shows enlarged appendix (arrow). Note increased attenuation of appendix as result of mucous inspissation.

 

Figure 14
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  		Fig. 14 —16-year-old girl with cystic fibrosis. Contrast-enhanced pelvic CT scan shows atypical appearance of ileocolonic intussusception (arrow).

 

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