MR cholangiography is becoming the modality of choice for noninvasive evaluation of the biliary tract and is an accurate diagnostic technique for identifying postoperative bile duct injuries. In general, bile duct injuries vary as to the type, severity and prognosis, and they are intimately related to the presence of congenital abnormalities of the biliary tract.

According to the Bismuth system (anatomic location), Type V refers to lesions affecting the right segmental hepatic duct variant with or without involvement of the main hepatic duct. Strictures of the aberrant right posterior hepatic duct lead to atypical patterns of segmental intrahepatic biliary dilatation and/or segmental liver fibrosis and cholangitis. The literature contains few articles describing the role of MRCP in this type of biliary injury. The purpose of this exhibit is to review the main anatomic variants of the right posterior duct, and particularly, to review and illustrate the main MRI and MRCP findings of Bismuth type V biliary injuries/strictures.