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. 2020 Nov 2;40(7):1866–1892. doi: 10.1148/rg.2020200195

Figure 18a.

Heterogeneous liver enhancement and biliary stasis in an 84-year-old woman with a history of hypertension and asthma who was admitted to the intensive care unit for hypoxic respiratory failure secondary to COVID-19 pneumonia and septic shock. The results of a laboratory test also confirmed elevated transaminase levels (aspartate transaminase, 1085 U/L; alanine transaminase, 741 U/L). The patient died 3 days later despite cholecystostomy placement. Axial (a) and coronal (b) CT angiographic images of the abdomen and pelvis show marked heterogeneous enhancement within the liver, with multiple areas of hypoenhancement along the biliary distribution (arrows in a). The gallbladder (GB) is distended, and there is a marked dilatation of the extrahepatic biliary duct (black arrow in b), with gradual tapering of the common bile duct within its distal segment (white arrow in b). No radiopaque obstructive stones or sludge were visualized. The findings are indicative of biliary stasis and an infectious or inflammatory process of the gallbladder. Note that the sensitivity of gallstone evaluation at CT is variable based on the composition of the stones.

Heterogeneous liver enhancement and biliary stasis in an 84-year-old woman with a history of hypertension and asthma who was admitted to the intensive care unit for hypoxic respiratory failure secondary to COVID-19 pneumonia and septic shock. The results of a laboratory test also confirmed elevated transaminase levels (aspartate transaminase, 1085 U/L; alanine transaminase, 741 U/L). The patient died 3 days later despite cholecystostomy placement. Axial (a) and coronal (b) CT angiographic images of the abdomen and pelvis show marked heterogeneous enhancement within the liver, with multiple areas of hypoenhancement along the biliary distribution (arrows in a). The gallbladder (GB) is distended, and there is a marked dilatation of the extrahepatic biliary duct (black arrow in b), with gradual tapering of the common bile duct within its distal segment (white arrow in b). No radiopaque obstructive stones or sludge were visualized. The findings are indicative of biliary stasis and an infectious or inflammatory process of the gallbladder. Note that the sensitivity of gallstone evaluation at CT is variable based on the composition of the stones.

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