Primary sclerosing cholangitis: MR imaging features.
OBJECTIVE
The purpose of this study was to evaluate the spectrum of MR imaging features of primary sclerosing cholangitis.


METHODS
A retrospective review was performed of MR imaging findings including MR cholangiography and multiphasic contrast-enhanced dynamic sequences in 22 patients with primary sclerosing cholangitis. MR imaging analysis included abnormalities of intra- and extrahepatic bile ducts, abnormalities of liver parenchyma, changes in liver morphology, and lymphadenopathy.


RESULTS
Abnormal findings of bile ducts were seen in all 22 patients; the most common finding was intrahepatic bile duct dilatation (77%), followed by intrahepatic bile duct stenosis (64%), extrahepatic bile duct wall enhancement (67%), extrahepatic bile duct wall thickening (50%), extrahepatic bile duct stenosis (50%), and intrahepatic bile duct beading (36%). Increased enhancement of the liver parenchyma on dynamic arterial-phase images, predominantly in the peripheral areas of the liver, was identified in 56% of patients. Other findings included periportal lymphadenopathy (77%), periportal high signal intensity on T2-weighted images (68%), hypertrophy of the caudate lobe (68%), and abnormal hyperintensity of the liver parenchyma on T1-weighted images (23%).


CONCLUSIONS
On MR imaging, primary sclerosing cholangitis showed several characteristic features, including bile duct abnormalities and increased enhancement of the liver parenchyma. MR cholangiography and contrast-enhanced dynamic MR techniques are useful for revealing intra- and extrahepatic signs of primary sclerosing cholangitis.
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Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Mitchell
D G
DG
Outwater
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EK
Blasbalg
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D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis; D008198:Lymph Nodes / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D003287:Contrast Media; D019786:Gadolinium DTPA