E2398. Acute Hepatobiliary Emergencies: Spectrum of MR Imaging
  1. Lucas Struycken; University of Arizona
  2. Hina Arif; University of Arizona
Abdominal pain is among the most commonly presenting symptoms in the Emergency Department, and while ultrasound (US) or computed tomography (CT) are often the initial imaging exam, magnetic resonance (MR) imaging plays a vital role in clinical scenarios in which accurate diagnosis relies on the greater sensitivity and specificity provided by MR imaging.

Educational Goals / Teaching Points
After reviewing this educational exhibit, the learner will be able to: - Understand the role of MR imaging of the abdomen in the accurate diagnosis of acute hepatobiliary emergencies. - To describe and illustrate the MR imaging findings in different types of acute hepatobiliary emergencies. - To utilize best practices for diagnosing hepatobiliary emergencies, including those of infectious, ischemic, neoplastic, traumatic, and obstructive etiologies.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will systematically illustrate the common clinical and imaging features of acute hepatobiliary emergencies in MR imaging, particularly those of primary hepatic, biliary, and gallbladder origin. The specific acute hepatobiliary emergencies discussed in this presentation will include: Liver: - Acute hepatitis - Abscess - Pyogenic, cholangitic - Perihepatic collection / abscess - Ischemia / Infarction Biliary: - Cholangitis - Malignant obstruction (cholangiocarcinoma: hilar, mid, and distal) - Benign obstruction (stone/stricture) - Bouveret syndrome - Mirrizi’s syndrome Gallbladder: - Acute cholecystitis - Gangrenous cholecystitis - Perforated cholecystitis - Hemorrhaging Emphysematous

In addition to systematically illustrating the common clinical and imaging features of acute hepatobiliary emergencies in MR imaging, this educational exhibit will present example cases and discuss best imaging practices of acute hepatobiliary emergencies, with pearls and pitfalls for optimizing efficient accurate diagnosis. Additionally, this exhibit shall address relevant management as applicable to the radiologist to aid in expedient, appropriate management.