Imaging of primary sclerosing cholangitis (PSC) by two new non-invasive techniques

Abstract

MR cholangiography (MRC) is a new technique which has already gained a role in PSC. Aim: to evaluate the ability of both MRC and CT eholangiography (CTC) to detect bile duct changes in PSC. Methods: MRC and CTC (with IV infusion of meglamine iotroxate) were performed in 12 PSC pts (8 M, 4 F, mean age 32 yrs). Diagnosis of PSC was previously obtained by ERCP and the mean duration of the disease was 36 months (range 24-60). The CTC data set was transferred to a Workstation Magic View (Siemens Medical Systems) to obtain 3D reconstructions (multiplanar reformatting, maximum intensity projection, and volume rendering technique). The MRC and CTC images were independently blinded analysed by 2 radiologists to assess the PSC involvement in the 1 ~t, 2 ~d, 3 ~d, and 4 ~' order intrahepatic bile ducts, in the extrahepatic bile ducts, and in the gallbladder. The quality of imaging was evaluated by the following grading system: excellent for complete delineation, good for delineation of at least 75%, fair for at least 50%, and non depiction. Localisation of the disease was recorded with the use of a five-point rating system. Results: the biliary tree was visualised in all patients with MRC and in 11/12 with CTC; the depiction of the biliary tree is reported in the table: