MR imaging and MR Cholangiopancreatography of multiple biliary hamartomas

Multiple biliary hamartomas (MBH), also known as von Meyenberg complexes, are rare benign malformations of the intrahepatic bile ducts. It is thought that MBH result from ductal plate malformations involving the small interlobular bile ducts. Proliferation of bile ducts’ cuboidal epithelium in fibrous stroma subsequently leads to duct dilation. Macroscopically, MBH appear as well-defined subcapsular or parenchymal grayish-white nodules less than 0.5 cm in diameter without true capsulation in an abundant fibrous stroma. MR imaging is considered the best imaging modality for demonstrating MBH. We herein reported MR imaging and MR cholangiopancreatography of a patient with typical MBH appearance. Multiple tiny T1 hypointense and T2 hyperintense lesions of uniform distribution in the hepatic parenchyma were revealed. At MR cholangiopancreatography, the lesions were also hyperintense. Maximum intense projection (MIP) of MR cholangiopancreatography showed uniformly distributed hyperintense lesions appearing as ‘‘starry sky’’ configuration.