Primary sclerosing cholangitis other imaging findings
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Primary sclerosing cholangitis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
ERCP was considered the gold standard for diagnosis of primary sclerosing cholangitis, because it allows visualization of the biliary tree. However, MRCP is now preferred because of its non-invasive nature. Findings on these imaging modalities include alternating areas of strictures and dilatations of the intrahepatic and extra hepatic bile ducts.
Other Imaging Findings
ERCP
ERCP has been regarded as the gold standard for diagnosis because it allows good visualization of the biliary system and the pancreas. However, MRCP is currently preferred due to its noninvasive nature.[1] Common findings include:[2]
- Multiple segmental strictures
- Biliary dilatation: may be present in ~85% of cases
- Biliary diverticula
- Mural irregularities
- Distortion of the biliary tree due to associated cirrhosis
MRCP
MRCP is preferred over ERCP due to several reasons, which include:[1][3][4][5]
- Non-invasive nature
- No use of radiation
- No need for antibiotic prophylaxis
- Cost-effectiveness
Imaging findings on MRCP are similar to those seen on ERCP.
References
- ↑ 1.0 1.1 Kumar A, Wheatley D, Puttanna A (2016). "Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management". Clin Med Insights Gastroenterol. 9: 25–9. doi:10.4137/CGast.S38451. PMC 4902039. PMID 27330336.
- ↑ Radiopedia.org PSC https://radiopaedia.org/articles/primary-sclerosing-cholangitis Accessed on Dec. 12, 2016.
- ↑ Lindor KD, Kowdley KV, Harrison ME (2015). "ACG Clinical Guideline: Primary Sclerosing Cholangitis". Am. J. Gastroenterol. 110 (5): 646–59, quiz 660. doi:10.1038/ajg.2015.112. PMID 25869391.
- ↑ Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). "Diagnosis and management of primary sclerosing cholangitis". Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.
- ↑ Dave M, Elmunzer BJ, Dwamena BA, Higgins PD (2010). "Primary sclerosing cholangitis: meta-analysis of diagnostic performance of MR cholangiopancreatography". Radiology. 256 (2): 387–96. doi:10.1148/radiol.10091953. PMID 20656832.