PMC10405802_01
Ultrasound of the upper abdomen. (A and B) Multiple hyperechoic masses within the dilated biliary radicals in right lobe of liver (red arrows); (C) On color Doppler, the lesions showed minimal vascularity (yellow arrow)
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F1
Ultrasound (US) of the upper abdomen revealed severe intrahepatic biliary dilatation involving the right lobe of the liver with multiple hyperechoic masses within the dilated bile ducts, which showed minimal vascularity on color Doppler examination (Fig. 1).
Triple phase CECT abdomen in (A) late arterial, (B) portal venous, and (C) delayed phases show multiple ill-defined variable sized lobulated lesions within dilated biliary radicals showing mild enhancement in late arterial phase (red arrow in A) with washout in portal venous and delayed phases (yellow arrows in B and C)
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F2
The lesions were seen to extend along and expand the right hepatic duct branches and reach up to the surface of liver causing mild contour bulge and irregularity (Fig. 2).
(A) Axial T1 weighted post-contrast and axial and coronal T2-weighted images. (B and C) Intraluminal papillary masses appearing hyperintense on T2-weighted images filling the suprapancreatic common bile duct, extending proximally into common hepatic duct, primary confluence and further into right hepatic duct and sectoral ducts of segments V, VI, and VII of right lobe of liver causing their aneurysmal dilatation (red arrows in B and C) with no significant post-contrast enhancement (yellow arrow in A); (D and E) Diffusion-weighted images with ADC maps show areas of restricted diffusion within the lesion (green arrow)
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F3
T1-weighted images, hyperintense on T2-weighted images and showed patchy areas of diffusion restriction. The lesions showed hypoenhancement (with respect to liver parenchyma) on post-contrast images (Fig. 3).
PMC10405802_02
Ultrasound of the upper abdomen. (A) Hyperechoic mass filling and expanding the common hepatic and proximal common bile duct (red arrow); (B) on color Doppler, the lesions no significant internal vascularity (yellow arrow)
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F4
The lesion did not show any significant internal vascularity on color Doppler (Fig. 4).
(A) Axial T1 weighted post-contrast and (B and C) axial and coronal T2-weighted images show irregular hypoenhancing (red arrow in A) soft tissue lesion in common hepatic duct and proximal common bile duct causing dilatation of the same (yellow arrow in B and C) appearing hyperintense on T2-weighted images; (D and E) Diffusion-weighted images with ADC maps show areas of restricted diffusion within the lesion (green arrow)
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F5