"There is an increased incidence in those with diabetes mellitus 2 and/or advanced atherosclerotic disease 7."
"MRI sometimes may be helpful in distinguishing pus from sludge by using heavily T2 weighted sequences, which may show fluid-fluid levels with dependent layering of purulent bile. On other MR sequences images, pus or purulent bile may be difficult to demonstrate 2. The purulent component is usually of lower signal on T2 weighted images 7,8."