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Insights into Imaging
Fig. 3 | Insights into Imaging

Fig. 3

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

Fig. 3

40-year-old male patient with COVID-19-associated SSC after severe COVID-19 infection with ARDS and ECMO requirement. a Axial fat-suppressed T2-weighted image shows mildly accentuated intrahepatic bile ducts with hyperintense peribiliary signal changes (arrows). b Maximum intensity projection MRCP image shows multifocal beading of the intrahepatic bile ducts (arrows) and multiple short-segment strictures (arrowheads). The extrahepatic biliary tree is spared (long arrows). c Post-contrast subtraction image in the arterial phase shows subtle inhomogeneous parenchymal enhancement with areas of hyperenhancement (arrows). d Hepatobiliary phase image acquired 20 min. after intravenous administration of gadoxetate disodium shows decreased hepatobiliary uptake with decreased liver-to-vessel-contrast. The patient underwent orthotopic liver transplantation and explant pathology revealed findings consistent with a severe ischemic cholangiopathy and grade F2 fibrosis

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