Choledocholithiasis

Discussion:

This case shows a large gallbladder stone and multiple CBD stones (choledocholithiasis) well seen on MRCP, which doesn't show up on CT (isodense stones). MRCP (MRI cholangiopancreatography) is a non-invasive MRI study of the biliary tracts. It has largely replaced ERCP as the gold standard for the diagnosis of choledocholithiasis. 3D reconstruction of heavily T2 sequence demonstrates a detailed anatomy of the biliary system.

Branch type intraductal papillary mucinous neoplasm (IPMN) of the pancreas is incidentally noted at the pancreatic body segment anteriorly. It is usually an incidental finding with low malignant potential compared to main duct type.

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