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Clinical History:
This is a 54-year-old Caucasian male with a past medical history of polymyositis and recent outside hospital admission for biliary tree obstruction with subsequent ERCP, cholecystectomy, and liver biopsy. He was admitted to our institution with elevated LFTs and abdominal pain.
Diagnosis:
Subcapsular/extracapsular hematoma
MR Technique:
3.0 T scanner (Siemens Verio) using a body matrix coil coupled with an eight-channel spine coil. Image 1: axial VIBE precontrast image (TR/TE 3.9/1.3 ms, scan time 15 sec, slice thickness 4.3 mm); Image 2: axial VIBE postcontrast image after administration of 0.1 mmol/kg of gadolinum chelate (TR/TE 4.0/1.4 ms, scan time 8 min 27 sec, slice thickness 4.3 mm); Images 3 and 4: axial T2-weighted turbo spin echo with fat saturation using respiratory gating (TR/TE 4967.5/79.0 ms, scan time 3 min 31 sec, thickness 5.0 mm).
Imaging Findings:
Non-enhancing T1/T2 subcapsular heterogeneous hyperintensity within the gallbladder fossa, extending into the paracolic gutter, consistent with hematoma. Similar T1/T2 hyperintensity adjacent to the caudate lobe, in keeping with a subcapsular hematoma.
