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Figure 2a. Acute cholecystitis caused by cystic duct obstruction due to an impacted calculus in a 65-year-old man with right upper quadrant pain. MR imaging was performed because the cause of the suspected acute cholecystitis could not be determined with US. (a) Image from single-section MR cholangiopancreatography shows a distended gallbladder with an impacted calculus (arrow) in the gallbladder neck. There is another calculus (*) in the gallbladder body. Note the small amount of pericholecystic fluid (arrowheads), which is markedly hyperintense. (b) Axial fat-suppressed T2-weighted image shows the distended gallbladder caused by the impacted stone (solid arrow). There is diffuse wall thickening with patchy high signal intensity (open arrows). Note the small amount of pericholecystic fluid (arrowhead), which is markedly hyperintense. (c) Coronal steady-state coherent image shows the impacted calculus (arrow) in the gallbladder neck. The impacted stone demonstrates predominant signal loss with a small central region of high signal intensity.
