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Hepatobiliary and Pancreatic MRI and MRCP Findings in Patients with HIV Infection

Mehmet Bilgin1,2, N. Cem Balci3, Ali Erdogan4, Amir Javad Momtahen3, Samer Alkaade5 and Wigbert S. Rau1

1 Department of Radiology, University Hospital Giessen and Marburg, Giessen, Germany.
2 Turkish–German Health Foundation, Giessen, Germany.
3 Department of Radiology, St. Louis University and St. Louis University Hospital, 3635 Vista Ave., St. Louis, MO 63110.
4 Department of Cardiology, University Hospital Giessen and Marburg, Giessen, Germany.
5 Department of Gastroenterology, St. Louis University, St. Louis, MO.


Figure 1
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  		Fig. 1A —48-year-old man with AIDS and Mycobacterium tuberculosis infection. On T1-weighted spoiled gradient-echo images (TR/TE, 140/4.4; flip angle, 70°) of liver, arterial phase (A) reveals nodular enhancement that fades on late phase (B).

 

Figure 2
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  		Fig. 1B —48-year-old man with AIDS and Mycobacterium tuberculosis infection. On T1-weighted spoiled gradient-echo images (TR/TE, 140/4.4; flip angle, 70°) of liver, arterial phase (A) reveals nodular enhancement that fades on late phase (B).

 

Figure 3
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  		Fig. 2A —43-year-old woman with HIV infection. MR cholangiopancreatography image reveals terminal segmental stricture of dilated common bile duct (CBD) (long arrow) as well as dilatation and side branch ectasia of main pancreatic duct (short arrows).

 

Figure 4
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  		Fig. 2B —43-year-old woman with HIV infection. On corresponding arterial phase T1-weighted fat-saturated spoiled gradient-echo MR images (TR/TE, 140/4.4; flip angle, 70°), pancreatic gland (arrow) enhances less on arterial phase (B) than on early venous phase (C).

 

Figure 5
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  		Fig. 2C —43-year-old woman with HIV infection. On corresponding arterial phase T1-weighted fat-saturated spoiled gradient-echo MR images (TR/TE, 140/4.4; flip angle, 70°), pancreatic gland (arrow) enhances less on arterial phase (B) than on early venous phase (C).

 

Figure 6
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  		Fig. 3A —52-year-old man with HIV infection. MR cholangiopancreatography (MRCP) image shows multiple gallstones (arrow).

 

Figure 7
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  		Fig. 3B —52-year-old man with HIV infection. Segmental stricture is present in terminal common bile duct that is better seen on a different MRCP projection (arrow, B) and on corresponding ERCP image (arrow, C).

 

Figure 8
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  		Fig. 3C —52-year-old man with HIV infection. Segmental stricture is present in terminal common bile duct that is better seen on a different MRCP projection (arrow, B) and on corresponding ERCP image (arrow, C).

 

Figure 9
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  		Fig. 4 —48-year-old man with HIV infection and acalculous cholecystitis. Contrast-enhanced T1-weighted spoiled gradient-echo image (TR/TE, 140/4.4; flip angle, 70°) shows gallbladder wall thickening and increased wall enhancement as well as pericholecystic fluid (arrow).

 

Figure 10
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  		Fig. 5A —54-year-old woman with HIV infection and right upper quadrant pain. MR cholangiopancreatography image shows multiple strictures (short thin arrows) that cause saccular dilatation of bile ducts and diffuse biliary dilatation of left liver lobe (short thick arrow). Segmental terminal common bile duct (CBD) stricture is also noted (long arrow).

 

Figure 11
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  		Fig. 5B —54-year-old woman with HIV infection and right upper quadrant pain. Corresponding contrast-enhanced late venous phase T1-weighted fat-saturated spoiled gradient-echo image shows intense enhancement of distal CBD wall (white arrow) and intrahepatic bile duct wall (black arrow).

 

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