Despite significant advances in hepatobiliary surgery, biliary injury and leakage remain typical postoperative complications. Thus, a precise depiction of the intrahepatic biliary anatomy and anatomical variant is crucial in preoperative evaluation. This study aimed to evaluate the precision of 2D and 3D magnetic resonance cholangiopancreatography (MRCP) in exact mapping of intrahepatic biliary anatomy and its variants anatomically in subjects with normal liver using intraoperative cholangiography (IOC) as a reference standard. Thirty-five subjects with normal liver activity were imaged via IOC and 3D MRCP. The findings were compared and statistically analyzed. Type I was observed in 23 subjects using IOC and 22 using MRCP. Type II was evident in 4 subjects via IOC and 6 via MRCP. Type III was observed equally by both modalities (4 subjects). Both modalities observed type IV in 3 subjects. The unclassified type was observed in a single subject via IOC and was missed in 3D MRCP. Accurate detection by MRCP of intrahepatic biliary anatomy and its anatomical variants was made in 33 subjects out of 35, with an accuracy of 94.3% and a sensitivity of 100%. In the remaining two subjects, MRCP results provided a false-positive pattern of trifurcation. MRCP competently maps the standard biliary anatomy.

We present a case of neglected atypical high grade prostatic stromal sarcoma (PSS) at the transitional zone , invading the peripheral zone, prostatic capsule & peri prostatic fat reaching to pelvic side wall, it showed T2WI hyperintense signal (compared to typical cases of PSS showing T2WI hypointense signal) corresponding to developing on top of pre-existing nodular hyperplasia. Careful reviewing of prostatic central / transitional zone lesions is mandatory especially at T2WI, diffusion & contrast images to exclude malignancy which can be easily missed due to multiple signal patterns described. Most common tumors at transitional zone is stromal sarcoma which could be typical showing T2 hypointense signal or atypical showing T2 hyperintense signal intensity.