Primary sclerosing cholangitis other imaging findings: Difference between revisions
Dima Nimri (talk | contribs) No edit summary |
Ahmed Younes (talk | contribs) No edit summary |
||
| (6 intermediate revisions by one other user not shown) | |||
| Line 5: | Line 5: | ||
==Overview== | ==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== | ==Other Imaging Findings== | ||
===ERCP=== | ===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.<ref name="pmid27330336">{{cite journal |vauthors=Kumar A, Wheatley D, Puttanna A |title=Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management |journal=Clin Med Insights Gastroenterol |volume=9 |issue= |pages=25–9 |year=2016 |pmid=27330336 |pmc=4902039 |doi=10.4137/CGast.S38451 |url=}}</ref> Common findings include:<ref name="Radiopedia"> Radiopedia.org PSC https://radiopaedia.org/articles/primary-sclerosing-cholangitis Accessed on Dec. 12, 2016. </ref> | |||
*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=== | ||
[[MRCP]] is preferred over [[ERCP]] due to several reasons, which include:<ref name="pmid27330336">{{cite journal |vauthors=Kumar A, Wheatley D, Puttanna A |title=Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management |journal=Clin Med Insights Gastroenterol |volume=9 |issue= |pages=25–9 |year=2016 |pmid=27330336 |pmc=4902039 |doi=10.4137/CGast.S38451 |url=}}</ref><ref name="pmid25869391">{{cite journal |vauthors=Lindor KD, Kowdley KV, Harrison ME |title=ACG Clinical Guideline: Primary Sclerosing Cholangitis |journal=Am. J. Gastroenterol. |volume=110 |issue=5 |pages=646–59; quiz 660 |year=2015 |pmid=25869391 |doi=10.1038/ajg.2015.112 |url=}}</ref><ref name="pmid20101749">{{cite journal |vauthors=Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ |title=Diagnosis and management of primary sclerosing cholangitis |journal=Hepatology |volume=51 |issue=2 |pages=660–78 |year=2010 |pmid=20101749 |doi=10.1002/hep.23294 |url=}}</ref><ref name="pmid20656832">{{cite journal |vauthors=Dave M, Elmunzer BJ, Dwamena BA, Higgins PD |title=Primary sclerosing cholangitis: meta-analysis of diagnostic performance of MR cholangiopancreatography |journal=Radiology |volume=256 |issue=2 |pages=387–96 |year=2010 |pmid=20656832 |doi=10.1148/radiol.10091953 |url=}}</ref> | |||
*Non-invasive nature | |||
*No use of radiation | |||
*No need for [[antibiotic]] prophylaxis | |||
*Cost-effectiveness<br> | |||
Imaging findings on [[MRCP]] are similar to those seen on [[ERCP]]. | |||
==References== | ==References== | ||
Latest revision as of 23:54, 13 February 2018
|
Primary sclerosing cholangitis Microchapters |
|
Differentiating Primary sclerosing cholangitis from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Primary sclerosing cholangitis other imaging findings On the Web |
|
American Roentgen Ray Society Images of Primary sclerosing cholangitis other imaging findings |
|
FDA on Primary sclerosing cholangitis other imaging findings |
|
CDC on Primary sclerosing cholangitis other imaging findings |
|
Primary sclerosing cholangitis other imaging findings in the news |
|
Blogs on Primary sclerosing cholangitis other imaging findings |
|
Directions to Hospitals Treating Primary sclerosing cholangitis |
|
Risk calculators and risk factors for Primary sclerosing cholangitis other imaging findings |
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.