Background
Gallstone disease is a common medical condition needing frequent surgical intervention. In the United States, around 500,000 cholecystectomies are performed annually. We will discuss the spectrum of MR Imaging and surgical pathology findings of gallstone-related complications.
Educational Goals / Teaching Points
Characteristic multiphase MRI findings seen with specific biliary pathologies related to gallstones in correlation with their intraoperative and gross specimen images with further discussion about management for the specific pathologies.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Gallstone disease is often asymptomatic until complicated. The travelling gallstone can produce a variety of complications, which is determined by the path of stone through the biliary tract and beyond. Most often these complications are due to ductal obstruction secondary to stone migration, inflammation or infection which include, but are not limited to the following etiologies as described: acute cholecystitis (acute uncomplicated cholecystitis and complicated cholecystitis including gangrenous cholecystitis, hemorrhagic cholecystitis, emphysematous cholecystitis, perforated cholecystitis), choledocholithiasis, ascending cholangitis, gallstone pancreatitis, mirizzi’s syndrome, bouveret syndrome, gallstone ileus, and dropped gallstones.
Conclusion
Multimodality approach is often needed for biliary imaging and MRI plays a crucial role in the diagnosis of gallstone-related complications and depiction of details of associated pathological processes. MRI/MRCP provides an excellent tissue contrast with high-resolution images of the biliary anatomy making this modality a valuable addition to US and CT.
