MRI of acute biliary emergencies

Congress:

ECR 2018

Poster Number:

C-1582

Type:

Educational Exhibit

Keywords:

Biliary Tract / Gallbladder, Abdomen, Emergency, MR, Education, Cholangiography, Acute, Inflammation, Dilatation, MR-Cholangiography

Authors:

M. Puglia¹, C. Massimo², R. Danzi², G. Gervasio³, I. Ferrara⁴, A. Ragozzino¹; ¹Napoli/IT, ²Naples/IT, ³Casandrino, NA/IT, ⁴Napoli (NA)/IT

DOI:

10.1594/ecr2018/C-1582

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1582

Fig. 1: Acute cholecystitis. (a) Axial TSE T2 fat sat (b) axial contrast e-enhanced...

Fig. 2: Ascending cholangitis. (a) MRCP MIP 3d T2, (b-c) coronal and axial single-shot...

Fig. 3: Mirizzi syndrome, type I. (a) Coronal single-shot TSE T2, (b)MRCP MIP TSE T2...

Fig. 4: Mirizzi syndrome, type II. (a) MRCP MIP 3D T2 and (b) coronal single-shot TSE...

Learning objectives

To illustrate MRI findings of biliary acute emergencies and complications of chronic biliary processes.

Background

Acute abdominal pain is one of the most common symptoms in adults presenting to the emergency department (about 7 million/year in USA). In acute hepatobiliary disorders diagnosis has to be precise and fast. Unsuitable assessment of acute biliary disorders can lead to delay in appropriate patient care and treatment, that can cause potentially life-threatening complications. US and CT are the early investigations of choice for their high sensitivity and speciﬁcity; however, the results of these modalities are not always conclusive therefore high contrast resolution of...

Findings and procedure details

The wide spectrum of acute biliary disorders is established as a result of different pathological conditions: inflammatory/infectious conditions, obstructions, perforations and trauma. We describe the biliary emergency conditions in which the MRI could provide more information than CT and US. Inflammatory/infectious diseases Acute cholecystitis is a very common surgical emergency. In about 90%-95% of cases, acute cholecystitis is caused by gallstone impaction in the neck of the gallbladder or cystic duct. As a result of the obstruction, bile stasis, ischemia, and development of systemic infection...

Conclusion

Evaluation of patients with acute biliary condition is common in diagnostic radiology. Although MDCT and US are the most used emergency abdominal imaging methods, the additional information provided by MRCP in the evaluation of patients with acute-biliary disorders, like suspected bile leak, complicated cholecystitis, biliary obstruction, and in traumatic disorders are invaluable. Familiarity with the optimal imaging protocols and imaging appearance of pathology is the key to an accurate diagnosis and patient management. MR imaging may prove to be a cost-effective strategy for imaging in...

Personal information

M. Puglia: Department of Advaced Biomedical Sciences - Diagnostic Imaging Section -"University Federico II - Naples" (Italy) C. Massimo: Department of Radiology , Santa Maria delle Grazie Hospital, Pozzuoli (Naples, Italy) R. Danzi: Department of Advaced Biomedical -Sciences- Diagnostic Imaging Section -"University Federico II - Naples" (Italy) G.Gervasio: Department of Radiology , Santa Maria delle Grazie Hospital, Pozzuoli (Naples, Italy) I. Ferrara: Department of Radiology , Santa Maria delle Grazie Hospital, Pozzuoli (Naples, Italy) A. Ragozzino: Department of Radiology , Santa Maria delle Grazie Hospital,...

References

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