title: MR imaging of acute biliary disorders.
abstract: In patients with acute right-sided epigastric pain, jaundice, and a high fever, it is essential to accurately diagnose the cause of the symptoms, differentiate acute biliary disorders from nonbiliary disorders, and evaluate the severity of the disease. Gray-scale ultrasonography (US) and computed tomography (CT) are useful primary imaging modalities, but their results are not always conclusive. Magnetic resonance (MR) imaging, including MR cholangiopancreatography, can be a valuable complement to US and CT when additional information is needed. MR images have excellent tissue contrast and can provide more specific information, allowing diagnosis of complications that arise from acute cholecystitis, such as empyema, gangrenous cholecystitis, gallbladder perforation, enterocholecystic fistula, emphysematous cholecystitis, and hemorrhagic cholecystitis. In addition, causes of obstructive jaundice, acute suppurative cholangitis, and hemobilia can be clearly demonstrated with multisequence MR imaging. Single-section MR cholangiopancreatography and heavily T2-weighted imaging, in combination with fat-suppressed T1- and T2-weighted imaging, provide comprehensive and detailed information about the biliary system around the obstruction site, biliary calculi, inflammatory processes, purulent material, abscesses, gas, and hemorrhage. Contrast-enhanced MR imaging is useful for evaluation of the gallbladder wall; lack of enhancement and disruption of the wall may be findings specific for gangrenous cholecystitis and gallbladder perforation, respectively.
authors: Department of Radiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki 710-8602, Japan. yw5904@kchnet.or.jp
authors: Yuji
authors: Y
authors: Watanabe
authors: Masako
authors: M
authors: Nagayama
authors: Akira
authors: A
authors: Okumura
authors: Yoshiki
authors: Y
authors: Amoh
authors: Takashi
authors: T
authors: Katsube
authors: Tsuyoshi
authors: T
authors: Suga
authors: Shingo
authors: S
authors: Koyama
authors: Kohya
authors: K
authors: Nakatani
authors: Yoshihiro
authors: Y
authors: Dodo
mesh_terms: D001659:Biliary Tract / Q000473:pathology*; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D003287:Contrast Media; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'
chemical_list: D003287:Contrast Media