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Insights into Imaging
Fig. 1 | Insights into Imaging

Fig. 1

From: Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

Fig. 1

70-year-old male patient who developed generalized pruritus and laboratory signs of hepatopathy a few months after recovering from a severe COVID-19 infection. MRI and MRCP of the liver with gadoxetate disodium was performed: a Axial T2-weighted image shows multifocal peripheral areas of mild biliary ductal dilatation and faint hyperintense parenchymal signal changes (arrows). b Peripheral parenchymal hyperintense signal changes are better seen on the fat-suppressed T2-weighted image (arrowheads). c Maximum intensity projection MRCP shows multiple strictures of the intrahepatic bile ducts (arrows) with upstream dilatation (arrowheads). The extrahepatic bile duct is spared (long arrows). d Post-contrast image in the arterial phase shows hyperenhancement in the peripheral parenchymal areas with hyperintense signal on high b-value diffusion-weighted images (e) and hypointensity in the hepatobiliary contrast phase (f) (arrowheads in d–f). Biopsy showed findings consistent with chronic cholestatic hepatopathy, bile duct damage and Stage F3 fibrosis

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