Related Experiment Videos
MR imaging findings of infectious cholangitis
T R Bader1, L Braga, K L Beavers
1Department of Radiology, University of North Carolina at Chapel Hill, USA.
Abstract:
The purpose of this study was to evaluate the appearance of infectious cholangitis on MRI. The MR images of 13 patients (9 women, 4 men; age range, 14-79 years) with clinically confirmed infectious cholangitis, who represent our complete 9.5 year experience with this entity, were retrospectively evaluated. All MR studies were performed at 1.5 T and included: in-phase and out-of-phase T(1)-weighted spoiled gradient echo (SGE), T(2)-weighted fat-suppressed echo train spin echo, single shot T(2)-weighted sequences, and serial postgadolinium T(1)-weighted SGE sequences without and with fat-suppression. The biliary ductal system was evaluated regarding presence of dilatation, stenosis, wall irregularities, wall thickening, and gadolinium enhancement of duct walls. The liver parenchyma was evaluated regarding focal signal abnormalities on precontrast and serial postgadolinium images. Biliary ductal dilatation was observed in 100% of patients. Mild to moderate thickening of bile duct walls combined with increased enhancement on postgadolinium images was observed in 92% of patients. The liver parenchyma showed periportal or wedge-shaped areas of hyperintense signal on T(2)-weighted images in 69% of patients. On T(1)-weighted images, 54% of patients showed areas of hypointense signal and 15% of patients showed wedge-shaped hyperintense areas. Areas with increased enhancement on immediate postgadolinium SGE were observed in 58% of patients, and in 42% of patients increased enhancement persisted on 2 min postgadolinium fat-suppressed images. Distinctive MRI findings on pre- and postgadolinium images are appreciated for infectious cholangitis.
Insights
Magnetic resonance imaging (MRI) reveals characteristic findings in infectious cholangitis, including biliary ductal dilatation and wall thickening. These distinctive MRI features aid in diagnosing infectious cholangitis.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Infectious cholangitis is a serious biliary infection.
- Accurate diagnosis is crucial for timely treatment.
- MRI offers detailed visualization of the biliary system.
Purpose of the Study:
- To evaluate the specific appearance of infectious cholangitis on MRI.
- To identify characteristic imaging findings associated with the condition.
Main Methods:
- Retrospective analysis of MRI scans from 13 patients with confirmed infectious cholangitis.
- Utilized various MRI sequences including T1-weighted, T2-weighted fat-suppressed, and post-gadolinium enhanced sequences.
- Assessed biliary ductal system for dilatation, stenosis, wall changes, and enhancement.
- Evaluated liver parenchyma for signal abnormalities.
Main Results:
- Biliary ductal dilatation was present in 100% of patients.
- Bile duct wall thickening and enhancement were observed in 92% of patients.
- Liver parenchyma abnormalities, including hyperintense T2 signals and altered T1 signals, were noted in a significant proportion of patients.
- Delayed gadolinium enhancement in affected areas was also observed.
Conclusions:
- MRI demonstrates distinctive findings in infectious cholangitis, including biliary ductal dilatation and wall abnormalities.
- Pre- and post-gadolinium enhanced MRI sequences are valuable for diagnosing infectious cholangitis.
- These imaging features assist in the clinical diagnosis and management of infectious cholangitis.