PMC2817546_01
Ultrasonography scan demonstrates an hyperechoic area with an acoustic shadow in the gallbladder fosse (arrow). These findings usually are suspected for sclero-atrophic or contracted lithiasic gallbladder.
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However, it demonstrated a hyperechoic area with an acoustic shadow in the gallbladder fossa, and this finding was suspected for sclero-atrophic to be contracted lithiasic gallbladder (Figure 1).
Transverse T2-weighted TSE sequences (up) and Coronal BALANCE sequences (down) do not visualize the gallbladder in the cholecystic fossa.
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The MRCP study consisted of a 3D-MIP breath-hold acquisition of a single slice in the coronal plane, positioned so as to obtain complete visualization of the intra- and extrahepatic biliary tract, with a single-slab RARE sequence (Figures 2 and 3).
3D-MIP breath-hold acquisition of a single slice in the coronal plane demonstrates the absence of both the gallbladder and the cystic duct or an ectopic gallbladder. The intrahepatic bile ducts appear normal with no images of stenosis or repletion defects. The hepatocholedocho is visualized until the second part of the duodenum, in correspondence to the Major papilla. Also the Wirsung duct demonstrates an anatomical variation; it is visualized until the initial part of the duodenum, in correspondence to the Minor papilla.
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The MRCP study consisted of a 3D-MIP breath-hold acquisition of a single slice in the coronal plane, positioned so as to obtain complete visualization of the intra- and extrahepatic biliary tract, with a single-slab RARE sequence (Figures 2 and 3). There were no images of cystic lesions in the intrahepatic area, in the lesser omentum, in the retroperitoneal and retrohepatic areas, within the falciform ligament, or in the retroduodenal area compatible with condition of ectopic gallbladder (Figure 3). 