Diagnosis of primary sclerosing cholangitis: a blinded comparative study using magnetic resonance cholangiography and endoscopic retrograde cholangiography

Moff, Stephen L.; Kamel, Ihab R.; Eustace, Joseph A.; Lawler, Leo P.; Kantsevoy, Sergey V.; Kalloo, Anthony N.; Thuluvath, Paul J.

doi:10.1016/j.gie.2005.12.034

Cited by 92 publications

(55 citation statements)

References 7 publications

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“…They concluded that MRC and ERC performed equally well in the diagnosis of PSC when used blinded to clinical information. In a separate study by Moff et al [29] , EHBD and IHBD visualization was excellent in 64% and 66% of MRCs, and 86% and 74% of ERCs. MRC had sensitivity ranging from 81%-91%, and specificity 85%-96% for diagnosis of PSC.…”

Section: Radiographymentioning

confidence: 89%

Primary sclerosing cholangitis - What is the difference between east and west?

Shorbagi¹,

Bayraktar²

2008

WJG

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Primary sclerosing cholangitis (PSC) is a chronic, progressive, cholestatic liver disease characterized by inflammation and fibrotic obliteration of the hepatic biliary tree. It is commonly associated with inflammatory bowel disease (IBD). A number of complications can occur which require special consideration, the most important of which is the development of cholangiocellular carcinoma (CCC). Unfortunately, no medical therapy is currently available for the underlying liver disease. Liver transplantation is an effective, lifeextending option for patients with advanced PSC. Geographical variations between East and West include a second peak for age with a lower association with IBD in a Japanese population and female predominance in a lone study from Turkey. The clinical and biochemical Mayo criteria may not be universally applicable, as different patients show variations regarding the initial presentation and natural course of the disease. Directing research towards explaining these geographical differences and understanding the pathogenesis of PSC is required in order to develop better therapies for this devastating disease.

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Section: Radiographymentioning

confidence: 89%

Primary sclerosing cholangitis - What is the difference between east and west?

Shorbagi¹,

Bayraktar²

2008

WJG

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“…Although ERCP has been regarded as the standard of reference in diagnosing PSC, MRC is now recommended as first line non-invasive imaging method for patients with suspected PSC, offering comparable accuracy (except in in early stage of PSC restricted into intrahepatic bile ducts and the rare cases of contraindications to MRC) (8)(9)(10)(11)(12). A meta-analysis based on six studies using ERCP as a reference method concluded that MRC has high sensitivity and specificity (0.86 and 0.94, respectively) for the diagnosis of PSC (13).…”

Section: Esge/easl Recommend That As the Primary Diagnostic Modalitymentioning

confidence: 99%

“…The specificity of the cholangiographic features of PSC without the additional diagnostic clinical and biochemical clues is poor (16). Of note, the visualization of the distal common bile duct and the peripheral intrahepatic ducts is still suboptimal using MRC (10,12). One study has suggested that a numerical score calculated based on three-dimensional MRC may predict progression of bile duct changes but the study lacked ERCP reference (17).…”

Section: Esge/easl Recommend That As the Primary Diagnostic Modalitymentioning

confidence: 99%

Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

Aabakken¹,

Karlsen²,

Albert³

et al. 2017

Journal of Hepatology

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“…9 MRCP is comparable with ERCP for the diagnosis of primary sclerosing cholangitis but less effective in diagnosis of dominant strictures. 10 Using ferritin as a marker of iron burden in SCD is complicated by ferritin itself being increased in both liver disease and inflammation. Baseline MRI, such as R2MRI measurements, is recommended to detect liver iron load.…”

Section: 3mentioning

confidence: 99%

How we treat sickle hepatopathy and liver transplantation in adults

Gardner

Suddle²,

Kane

et al. 2014

Blood

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Sickle cell disease (SCD) has evolved into a debilitating disorder with emerging end-organ damage. One of the organs affected is the liver, causing “sickle hepatopathy,” an umbrella term for a variety of acute and chronic pathologies. Prevalence of liver dysfunction in SCD is unknown, with estimates of 10%. Dominant etiologies include gallstones, hepatic sequestration, viral hepatitis, and sickle cell intrahepatic cholestasis (SCIC). In addition, causes of liver disease outside SCD must be identified and managed. SCIC is an uncommon, severe subtype, with outcome of its acute form having vastly improved with exchange blood transfusion (EBT). In its chronic form, there is limited evidence for EBT programs as a therapeutic option. Liver transplantation may have a role in a subset of patients with minimal SCD-related other organ damage. In the transplantation setting, EBT is important to maintain a low hemoglobin S fraction peri- and posttransplantation. Liver dysfunction in SCD is likely to escalate as life span increases and patients incur incremental transfusional iron overload. Future work must concentrate on not only investigating the underlying pathogenesis, but also identifying in whom and when to intervene with the 2 treatment modalities available: EBT and liver transplantation.

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Diagnosis of primary sclerosing cholangitis: a blinded comparative study using magnetic resonance cholangiography and endoscopic retrograde cholangiography

Cited by 92 publications

References 7 publications

Primary sclerosing cholangitis - What is the difference between east and west?

Primary sclerosing cholangitis - What is the difference between east and west?

Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

How we treat sickle hepatopathy and liver transplantation in adults

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