Primary sclerosing cholangitis: a modified classification of cholangiographic findings.

Hepatobiliary and pancreatic: Commentary

“…This corresponds to extrahepatic type IV in combination with intrahepatic type II by the classification of Majoie et al . 1 Abdominal enhanced computed tomography showed thickening of the biliary tract wall (Fig. 3).…”

Primary sclerosing cholangitis

“…The diagnosis is missed in some patients with isolated intrahepatic disease unless these techniques are used [6]. The radiologic appearances of PSC represent a broad spectrum of cholangiographic features [7][8][9]. The gallbladder and cystic duct are usually spared.…”

“…2) and webs (short band-like strictures) have been considered by several authors to be specific cholangiographic features of PSC [2,5,7,9]. The experience of other authors suggests, however, that these findings can be seen, though rarely, in patients without PSC [10].…”

“…In a small number of cases only the intrahepatic or extrahepatic ducts are involved [7][8][9]. When only intrahepatic duct involvement is demonstrated, differentiation must be made from primary biliary cirrhosis.…”

“…Extensive dilatation of the intrahepatic ductal system is more often seen with carcinoma and is uncommon with PSC. However, cholangiocarcinoma must be considered when there is stenosis of the extrahepatic duct; brush cytology or, when negative, biopsy may be necessary to exclude it [9]. Because PSC may be predisposed to malignant change, the possibility of malignancy must be considered during initial presentation as well as at follow-up.…”