Case of hepatolithiasis diagnosed by magnetic resonance cholangiography

We report a case of hepatolithiasis in which cholangiography by magnetic resonance (MR) imaging was useful in making a detailed diagnosis. Sonograms showed a high echoic lesion in the liver, and computed tomograms showed dilated intrahepatic bile ducts and atrophic hepatic tissue. By ordinary cholangiography, these findings were not made because of obstruction of the bile ducts by the stones. In MR cholangiograms, intrahepatic stones in dilated bile ducts in the posterior segment were seen, as were dilated bile ducts in the peripheral part of this segment. Posterior segmentectomy was done. The operative specimens had stones in the dilated bile ducts, and hepatic tissue was atrophic. MR cholangiography is useful to diagnose not only hepatolithiasis but also dilatation in the bile ducts. MR cholangiography should be tried if other examinations do not give sufficient information.