MR cholangiography in primary sclerosing cholangitis.

Ernst, Olivier; Asselah, Tarik; Sergent, Géraldine; Calvo, Mari M; Talbodec, N.; Jc, Paris; L’Herminé, C

doi:10.2214/ajr.171.4.9762990

Cited by 78 publications

(28 citation statements)

References 4 publications

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“…A short signal void in the common bile duct is considered an artifact caused by the hepatic artery. b Corresponding endoscopic retrograde cholangiopancreatography several hepatic segments is characteristic of SC [17,22,23] and corresponds well with the histologically described pattern of periportal fibrosis with both destruction and proliferation of smaller bile ducts. The short signal void in the CBD seen in MRCP but not in ERCP was presumably artificial in the vicinity of the dilated hepatic artery.…”

Section: Discussionsupporting

confidence: 65%

MR cholangiography in the diagnosis of sclerosing cholangitis in Langerhans' cell histiocytosis

et al. 2001

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Langerhans' cell histiocytosis (LCH) is a disorder of histiocytic proliferation that primarily affects infants. Imaging findings of a rare case of lung and liver involvement in an adult are presented. High-resolution computed tomography (HRCT) of the lungs showed confluent thin-walled cystic air spaces compatible with advanced LCH. Liver CT and MRI revealed unspecific signs of fatty infiltration. Irregular widening of peripheral bile ducts was displayed in breath-hold MR cholangiography. This pattern is considered characteristic for sclerosing cholangitis and should support the diagnosis of LCH in case of concomitant cystic pulmonary disease, even in adult patients.

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Section: Discussionsupporting

confidence: 65%

MR cholangiography in the diagnosis of sclerosing cholangitis in Langerhans' cell histiocytosis

et al. 2001

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“…Two reports suggest a good correlation between MRC and ERCP in the diagnosis of SC. 31,36 In a prospective case-control study involving 102 patients, Fulcher et al 9 compared the MR cholangiograms obtained in 34 patients with PSC to those of 68 age-matched control patients with various hepatobiliary diseases, 6 of whom had AIH. In the detection of intrahepatic PSC, the reported sensitivity and specificity of MRC were between 85% and 88% and between 92% and 97%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis: Evaluating the role of routine magnetic resonance imaging

et al. 2007

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Large bile duct injury (that seen on cholangiography) is not usually considered a feature of autoimmune hepatitis (AIH) in adults but is present in up to 50% of children with AIH. The aim of this work was to study the prevalence of large bile duct abnormalities identified by magnetic resonance cholangiography (MRC) in adults given a diagnosis of AIH. Seventy-nine (n ‫؍‬ 79) patients given a diagnosis of AIH (mean AIH score: 15.1 ؎ 3.4) were screened with MRC for evidence of sclerosing cholangitis (SC). Results were reviewed by two radiologists. Clinical parameters were correlated with MRC findings. A histological review of available liver biopsies (n ‫؍‬ 29) was performed. Of the 79 patients surveyed, 8 (10%) had MRC findings consistent with primary sclerosing cholangitis (PSC). The interrater variability was excellent (kappa ‫؍‬ 0.87). Younger age at diagnosis (24.3 ؎ 11.9), higher baseline alkaline phosphatase (186.4 ؎ 98.3), higher bilirubin at time of MRC (45.8 ؎ 37.2), and greater lobular activity on initial liver biopsy were significantly associated with the detection of this overlap of SC with AIH (P ‫؍‬ 0.024, P ‫؍‬ 0.037, P ‫؍‬ 0.032, and P ‫؍‬ 0.041, respectively), but not alkaline phosphatase/aspartate aminotransferase ratio, time between the initial diagnosis of AIH and the MRC, or the presence of cirrhosis on initial liver histology. Two cases with a normal MRC had histological lesions typical of small duct PSC. Conclusion: The presence of SC detected by MRC and from liver histology in adult patients with AIH may not be clinically overt, and thus the prevalence of this AIH/SC overlap may be higher than previously recognized. Our data suggest that routine radiological evaluation of the biliary tree should be performed in adults given a diagnosis of AIH, as in children the presence of this overlap negatively impacts on survival. (HEPATOLOGY 2008;47:949-957.)

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“…On the other hand, MRC is relatively superior to ERCP in demonstrating dilated ducts above an obstruction. The investigators have noted that in some cases MRC may be deficient in determination of length of strictures below an obstructed duct [48] . Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CCA, using 37 ng/ml as the cut-off level for CA19-9 and 5 ng/ml for CEA.…”

Section: Imaging In Pscmentioning

confidence: 99%

Surveillance and Screening of Primary Sclerosing Cholangitis

Fouly¹,

Dechêne²,

Gerken³

2009

Dig Dis

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Primary sclerosing cholangitis (PSC) represents an idiopathic chronic cholestatic liver disease due to inflammatory destruction of the biliary tree. Clinically, the progressive disease leads to biliary cirrhosis in association with cholangiocarcinoma in 6–20% of the patients. Currently, liver transplantation remains the only life-extending treatment option in end-stage disease. However, due to the high risk of carcinoma development, PSC patients should be tightly screened and evaluated including newer technologies like endoscopic ultrasound-guided fine-needle aspiration biopsy and cholangioscopy including cytology and direct biopsy of the biliary mucosal lesions.

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MR cholangiography in primary sclerosing cholangitis.

Cited by 78 publications

References 4 publications

MR cholangiography in the diagnosis of sclerosing cholangitis in Langerhans' cell histiocytosis

MR cholangiography in the diagnosis of sclerosing cholangitis in Langerhans' cell histiocytosis

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis: Evaluating the role of routine magnetic resonance imaging

Surveillance and Screening of Primary Sclerosing Cholangitis

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