MR Imaging Features of Primary Sclerosing Cholangitis: Patterns of Cirrhosis in Relationship to Clinical Severity of Disease

Bader, Till R.; Beavers, Kimberly L.; Semelka, Richard C.

doi:10.1148/radiol.2263011623

Cited by 90 publications

(70 citation statements)

References 46 publications

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“…They were indeed observed in more than half of SC patients who had imaging findings suggestive of cirrhosis. 28 In conclusion, our data do not support the need for routine radiological evaluation of the biliary tree in adults with a diagnosis of AIH. Indeed, the prevalence of overlapping SC in these patients appears very low-below 2% in the present study.…”

Section: Discussioncontrasting

confidence: 76%

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis

et al. 2009

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The development of sclerosing cholangitis (SC) is observed in up to 50% of children followed up for autoimmune hepatitis (AIH). In adults, the prevalence is less known, although a recent study found evidence of SC in 10% of AIH patients using magnetic resonance cholangiopancreatography (MRCP). The aim of this study was to assess prospectively the prevalence of SC in adults with AIH. Fifty-nine consecutive patients with AIH diagnosed according to International Autoimmune Hepatitis Group score (women, 71%; mean age, 48 years; cirrhosis, 23%) underwent both MRCP and percutaneous liver biopsy. Twenty-seven patients with cirrhosis of nonbiliary or non-autoimmune etiology served as controls. Fourteen AIH patients (24%) showed mild MRCP abnormalities of intrahepatic bile ducts (IHBDs). None had abnormal common bile duct or convincing evidence of SC on MRCP or biopsy. A diagnosis of overlapping SC was nevertheless retained in one patient with MRCP abnormalities who subsequently developed symptomatic cholestasis despite corticosteroid therapy. Fibrosis score was the only independent parameter associated with bile duct abnormalities on MRCP (odds ratio 2.4; 95% confidence interval 1.4-4.7) and the percentage of patients with IHBD MRCP abnormalities was not different among F3-F4 AIH patients (n ‫؍‬ 24) and cirrhotic controls (46% versus 59%; NS). Conclusion: In this cohort of adult patients with AIH, the prevalence of SC was much lower than previously reported (1.7%). Mild MRCP abnormalities of IHBD were seen in a quarter of patients, but these abnormalities resulted from hepatic fibrosis and not SC. In the absence of cholestatic presentation, MRCP screening does not seem justified in adult-onset AIH. (HEPATOLOGY 2009;50:528-537.)

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Section: Discussioncontrasting

confidence: 76%

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis

et al. 2009

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“…As to the absence of first ductules, it is important for clinical practice for two reasons: the first as a sign of fibro-obliterative deseases [18][19][20][21][22][23][24][25][26] and the second considering minimum detectable duct caliber in imaging radiologic researches [27][28][29]. From LDLT point of view it is important in evaluation of age and functional-size-mass related liver parenchyma changes for donors and recipients.…”

Section: Discussionmentioning

confidence: 99%

Aberrant Confluence of Intrahepatic Biliary Ducts - A Case Report

Jurkovikj

Korneti-Pekevska

2013

Maced J Med Sci

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Aim: Besides the most frequent-modal type of confluent patterns intrahepatic biliary ducts, there are cases with aberrant type of confluence. The aim of this report is to present a case with aberrant confluence of intrahepatic biliary ducts. Material and Methods:Injection-corrosive method was used to obtain acrylic cast from biliary and portal systems of one human liver. Biliary ducts were followed parallel to the adjoint portal ramification from the initial part of segmental ductules.

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“…In PSC, insufficient biliary drainage of the more peripheral aspects of the liver (rather than decreased portal venous flow) ultimately results in peripheral fibrosis and atrophy [5,6]. In addition to the morphologic changes, the scattered, irregular biliary duct dilatation that is the hallmark of PSC should allow a confident diagnosis at CT.…”

Section: Discussionmentioning

confidence: 99%

“…However, portal vein thrombus does not necessarily result in cirrhosis. Indeed, recent studies in the pathology literature have indicated that alterations in portal venous flow result in a spectrum of altered hepatic histology, ranging from large regenerative nodules to nodular regenerative hyperplasia [4][5][6]. Unfortunately, the gross macroscopic changes in hepatic contour that may occur after primary portal venous occlusion are often mistaken for cirrhosis, even though bridging fibrosis is absent at histologic evaluation.…”

Section: Introductionmentioning

confidence: 99%

Altered Liver Morphology After Portal Vein Thrombosis: Not Always Cirrhosis

et al. 2008

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The macroscopic appearance of the liver after primary portal vein thrombosis often mimics cirrhosis, despite the absence of bridging fibrosis at histology. The purpose of this study was to describe unique morphologic changes of the liver after portal venous thrombosis. A retrospective review was performed to find patients with portal vein thrombosis and a corresponding noncirrhotic liver biopsy. The CT appearance of the liver was then evaluated, and the liver was categorized as having either peripheral or central hepatic atrophy. Of 15 patients included in this study, 12 had peripheral atrophy of the liver, while the remaining three had central atrophy. We concluded that maintenance of central portal venous blood flow and resultant relative peripheral atrophy of the liver may account for a distinctive rounded configuration of the liver after acute portal vein thrombosis. Awareness of this appearance after primary portal vein thrombosis may prevent an erroneous diagnosis of cirrhosis.

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MR Imaging Features of Primary Sclerosing Cholangitis: Patterns of Cirrhosis in Relationship to Clinical Severity of Disease

Abstract: The spectrum of MR imaging appearances of PSC is diverse and comprises distinct patterns that do not appear to correlate with severity of disease. Large regenerative nodules are a frequent finding and may help to establish the diagnosis.

Cited by 90 publications

References 46 publications

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis

Prevalence of sclerosing cholangitis in adults with autoimmune hepatitis

Aberrant Confluence of Intrahepatic Biliary Ducts - A Case Report

Altered Liver Morphology After Portal Vein Thrombosis: Not Always Cirrhosis

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