Comparison of sclerosing cholangitis with autoimmune pancreatitis and infiltrative extrahepatic cholangiocarcinoma: multidetector-row computed tomography findings.
OBJECTIVE
The aim of this study was to compare multidetector-row computed tomography (MDCT) findings between cases of sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and infiltrative extrahepatic cholangiocarcinoma (IEC).


METHODS
We retrospectively assessed MDCT findings from 16 IEC cases and 13 SC-AIP cases. MDCT findings were analyzed with regard to location, length, wall thickness, contour, stricture wall enhancement pattern, proximal duct diameter, and the presence of diffuse concentric thickening in the proximal duct and gallbladder wall thickness.


RESULTS
Stricture length, stricture wall thickness, and proximal duct diameter were significantly smaller for SC-AIP than for IEC: 19.3 +/- 8.7 vs. 31.8 +/- 12.0 mm (P = 0.004), 2.1 +/- 1.3 vs. 4.1 +/- 1.3 mm (P < 0.001), and 9.2 +/- 3.9 vs. 13.3 +/- 5.0 mm (P = 0.012), respectively. SC-AIP was correlated with stricture location in both the intrapancreatic and hilar hepatic bile ducts, concentric stricture contour (P < 0.001), and diffuse concentric thickening of the proximal bile duct (P = 0.010). Overall values of sensitivity, specificity, and accuracy used to distinguish between SC-AIP and IEC for stricture wall thickness of <3.0 mm and concentric contour were 76.9%, 93.8%, and 86.2%, respectively, and 100%, 87.5%, 93.1%, respectively.


CONCLUSIONS
Concentric contour and stricture wall thicknesses of <3.0 mm may help distinguish between SC-AIP and IEC.
Arikawa
Shunji
S
Department of Radiology, Kurume University School of Medicine, Kurume, Japan.
Uchida
Masafumi
M
Kunou
Yukiko
Y
Uozumi
Jun
J
Abe
Toshi
T
Hayabuchi
Naofumi
N
Ishida
Yusuke
Y
Kaji
Ryohei
R
Okabe
Yoshinobu
Y
Murotani
Kenta
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D017734:Bile Ducts, Extrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging*; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed