Radiologic manifestations of sclerosing cholangitis with emphasis on MR cholangiopancreatography.
Publication/Presentation Date
1-1-2000
Abstract
Magnetic resonance cholangiopancreatography (MRCP) is a relatively new, noninvasive cholangiographic technique that is comparable with invasive endoscopic retrograde cholangiopancreatography (ERCP) in the detection and characterization of extrahepatic bile duct abnormalities. The role of MRCP in evaluation of the intrahepatic bile ducts, especially in patients with primary or secondary sclerosing cholangitis, is under investigation. The key cholangiographic features of primary sclerosing cholangitis are randomly distributed annular strictures out of proportion to upstream dilatation. As the fibrosing process worsens, strictures increase and the ducts become obliterated, and the peripheral ducts cannot be visualized to the periphery of the liver at ERCP. In addition, the acute angles formed with the central ducts become more obtuse. With further progression, strictures of the central ducts prevent peripheral ductal opacification at ERCP. Cholangiocarcinoma occurs in 10%-15% of patients with primary sclerosing cholangitis; cholangiographic features that suggest cholangiocarcinoma include irregular high-grade ductal narrowing with shouldered margins, rapid progression of strictures, marked ductal dilatation proximal to strictures, and polypoid lesions. Secondary sclerosing and nonsclerosing processes can mimic primary sclerosing cholangitis at cholangiography. These processes include ascending cholangitis, oriental cholangiohepatitis, acquired immunodeficiency syndrome-related cholangitis, chemotherapy-induced cholangitis, ischemic cholangitis after liver transplantation, eosinophilic cholangitis, and metastases.
Volume
20
Issue
4
First Page
959
Last Page
975
ISSN
0271-5333
Published In/Presented At
Vitellas, K. M., Keogan, M. T., Freed, K. S., Enns, R. A., Spritzer, C. E., Baillie, J. M., & Nelson, R. C. (2000). Radiologic manifestations of sclerosing cholangitis with emphasis on MR cholangiopancreatography. Radiographics : a review publication of the Radiological Society of North America, Inc, 20(4), 959–1112. https://doi.org/10.1148/radiographics.20.4.g00jl04959
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
10903686
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article