title: Prevalence of Sclerosing Cholangitis Detected by Magnetic Resonance Cholangiography in Patients With Long-term Inflammatory Bowel Disease.
abstract: The prevalence of primary sclerosing cholangitis (PSC) among patients with inflammatory bowel disease (IBD) is unclear. Patients with IBD might be screened for PSC using magnetic resonance cholangiography (MRC). We aimed to estimate the frequency and distribution of MRC-detected lesions that indicate PSC in patients with IBD 20 years after their initial diagnosis and to identify clinical characteristics associated with these findings.
  
  
  
  We performed a follow-up analysis of a population-based cohort of 756 patients in South-Eastern Norway diagnosed with IBD from January 1, 1990 through December 31, 1993. Of these subjects, 470 attended a follow-up evaluation 20 years later in which they were offered routine clinical blood testing and ileocolonoscopy; 322 were screened by MRC (222 with ulcerative colitis and 100 with Crohn's disease). Two radiologists independently evaluated results from the MRC examinations.
  
  
  
  In the MRC examination, 24 patients (7.5%) were found to have PSC-like lesions; only 7 of these patients (2.2%) were known to have PSC. One patient was initially missed and 1 had small-duct PSC, so the final prevalence of PSC was 8.1%. Extensive colitis, a high prevalence of colectomy, and chronic and continuous symptoms of IBD occurred in significantly more patients with suspected PSC than without PSC (P = .029, P = .002, and P = .012, respectively). Among patients with subclinical features of PSC, the MRC progression score for PSC increased when they were re-examined after a median 3.2 years (P = .046).
  
  
  
  Using MRC analysis of patients with long-term IBD, we found the prevalence of PSC to be around 3-fold higher than that detected based on symptoms. Sixty-five percent of patients had subclinical PSC associated with progressive IBD, with no biochemical abnormalities and mild disease, based on radiology findings. PSC appears to progress in patients with subclinical disease, but long-term outcomes are not known.
authors.affiliation: Department of Radiology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: aida.k.lunder@gmail.com.
authors.forename: Aida Kapic
authors.initials: AK
authors.lastname: Lunder
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Section for Gastroenterology, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; K. G. Jebsen Inflammation Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Johannes Roksund
authors.initials: JR
authors.lastname: Hov
authors.affiliation: Department of Radiology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Arne
authors.initials: A
authors.lastname: Borthne
authors.affiliation: Department of Radiology, Østfold Hospital, Fredrikstad, Norway.
authors.forename: Jostein
authors.initials: J
authors.lastname: Gleditsch
authors.affiliation: Department of Radiology, Telemark Hospital, Skien, Norway.
authors.forename: Glenn
authors.initials: G
authors.lastname: Johannesen
authors.affiliation: Røntgensenteret, Kristiansand, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Tveit
authors.affiliation: Department of Radiology, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Ellen
authors.initials: E
authors.lastname: Viktil
authors.affiliation: Department of Gastroenterology, Østfold Hospital, Fredrikstad, Norway.
authors.forename: Magne
authors.initials: M
authors.lastname: Henriksen
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Innlandet Hospital, Gjøvik, Norway.
authors.forename: Øistein
authors.initials: Ø
authors.lastname: Hovde
authors.affiliation: Department of Gastroenterology, Telemark Hospital, Skien, Norway.
authors.forename: Gert
authors.initials: G
authors.lastname: Huppertz-Hauss
authors.affiliation: Department of Gastroenterology, Sørlandet Hospital, Arendal, Norway.
authors.forename: Ole
authors.initials: O
authors.lastname: Høie
authors.affiliation: Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Marte Lie
authors.initials: ML
authors.lastname: Høivik
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Iril
authors.initials: I
authors.lastname: Monstad
authors.affiliation: Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Inger Camilla
authors.initials: IC
authors.lastname: Solberg
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Jahnsen
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Section for Gastroenterology, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; K. G. Jebsen Inflammation Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Research Institute of Internal Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Tom Hemming
authors.initials: TH
authors.lastname: Karlsen
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Moum
authors.affiliation: Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; EpiGen Institute, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Morten
authors.initials: M
authors.lastname: Vatn
authors.affiliation: Department of Radiology, Akershus University Hospital, Lørenskog, Norway; Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Anne
authors.initials: A
authors.lastname: Negård
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods / Q000706:statistics & numerical data*; D015209:Cholangitis, Sclerosing / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000150:complications* / Q000601:surgery; D003424:Crohn Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D013997:Time Factors
keywords: Biliary Tract Disease; Epidemiology; Liver Disease; Magnetic Resonance Imaging