MR characteristics of acute cholangitis

Purpose: To describe the MR appearance of acute cholangitis and discuss the role of MR imaging as a diagnostic method in this disease. Material and Methods: Of 60 patients with clinical acute cholangitis, 12 were examined with MR before endoscopic retrograde pancreatography (ERCP). A retrospective review was performed of MR and ERCP findings. The MR findings registered were presence of biliary duct dilatation, intraluminal filling defects due to stones or sludge, bands of mucosal oedema of the biliary ducts, intra- and retroperitoneal oedema/fluid, and definition of the cause of obstruction, e.g. stones, stenosis or tumour was made. Results: Acute cholangitis was related to obstruction from choledocholithiasis (n = 8), pancreatic cancer (n = 1), benign biliary duct stricture (n = 1), papillary stenosis (n = 1) and without evidence of an obstructing cause (n = 1). One patient had an acute obstructive suppurative (toxic) cholangitis. Conclusion: MR imaging has a role in the non-invasive radiographic arsenal of techniques to confirm or exclude the diagnosis of acute cholangitis, especially in older patients where the clinical symptoms may be vague.