MR imaging findings of infectious cholangitis

The purpose of this study was to evaluate the appearance of infectious chol angitis 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 eva luated. All MR studies were performed at 1.5 T and included: in-phase and o ut-of-phase T-1-weighted spoiled gradient echo (SGE), T-2-weighted fat-supp ressed 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 a bnormalities on precontrast and serial postgadolinium images. Biliary ducta l dilatation was observed in 100% of patients. Mild to moderate thickening of bile duct walls combined with increased enhancement on postgadolinium im ages was observed in 92% of patients. The liver parenchyma showed periporta l 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 hypo intense signal and 15% of patients showed wedge-shaped hyperintense areas. Areas with increased enhancement on immediate postgadolinium SGE were obser ved in 58% of patients, and in 42% of patients increased enhancement persis ted on 2 min postgadolinium fat-suppressed images. Distinctive MRI findings on pre- and postgadolinium images are appreciated for infectious cholangit is. (C) 2001 Elsevier Science Inc. All rights reserved.