title: MRI of perforated gall bladder.
abstract: Gall bladder perforation is a dreaded complication of acute cholecystitis that, if not diagnosed early in the course, might have a poor prognosis. Both CT and ultrasonography have been used until now extensively for the diagnosis of acute cholecystitis, but diagnosis of perforation is always difficult. Magnetic resonance, by its superior soft tissue resolution and multiplanar capability, is a better modality and should fare better than ultrasonography and CT, as demonstrated in our case. Magnetic resonance imaging demonstrates the wall of the gall bladder and defects to a much better advantage and more convincingly. In addition, MR colangiopancreatography images demonstrate the biliary tree better than other modalities. We suggest that in the case of acute cholecystitis, if perforation is suspected and CT and ultrasonography are not conclusive, MR should be the modality of choice. It can be used as a first line of investigation; however, it might not be cost-effective.
authors.affiliation: Department of Medical Imaging, University of Queensland, Toowoomba Base Hospital, Australia. bimal_sood@health.qld.gov.au
authors.forename: Bimal
authors.initials: B
authors.lastname: Sood
authors.forename: Manoj
authors.initials: M
authors.lastname: Jain
authors.forename: Niranjan
authors.initials: N
authors.lastname: Khandelwal
authors.forename: Paramjit
authors.initials: P
authors.lastname: Singh
authors.forename: Sudra
authors.initials: S
authors.lastname: Suri
mesh_terms: D002764:Cholecystitis / Q000150:complications / Q000175:diagnosis; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis; D005260:Female; D005704:Gallbladder / Q000473:pathology; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012422:Rupture, Spontaneous