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Insights into Imaging
Fig. 4 | Insights into Imaging

Fig. 4

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

Fig. 4

61-year-old male patient with COVID-19-associated SSC after severe COVID-19 infection and prolonged ICU stay. a Axial non-fat-suppressed and (b) fat-suppressed T2-weighted images show mild hyperintense signal changes predominantly in the right hepatic lobe (arrows in a and b) with subtle bile duct dilatation (arrowheads in a and b). The caudate lobe is enlarged, and the hepatic contours are rounded (long arrows in a and b). c Maximum intensity projection MRCP image shows irregularities of the intrahepatic bile ducts with beading and multifocal structuring (arrows). The extrahepatic biliary tree is spared (long arrows). d Post-contrast images in the arterial phase show diffuse areas of patchy hyperenhancement especially in peripheral areas of the right hepatic lobe (arrows). d The post-contrast images in the hepatobiliary phase show patchy hypointense changes representing areas of decreased of hepatobiliary contrast agent uptake (arrows). f Color stiffness map from MR elastography shows increased stiffness of the liver parenchyma (arrows) as represented by the yellow to red color coding (mean liver stiffness was 6.4 kPa)

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