Abstract
Primary sclerosing cholangitis (PSC) is a chronic liver disease in which there are inflammation and scarring of the bile ducts leading to fibrosis, destruction and narrowing of the bile ducts, resulting in cholestasis. In the long run, PSC can cause liver cirrhosis and failure. In clinical practice, the diagnosis of PSC is generally based on blood tests and imaging studies (currently preferably magnetic resonance cholangiopancreatography). To make a diagnosis of PSC it is necessary to exclude secondary causes of sclerosing cholangitis. The most common MRI features of PSC concerning bile ducts are: bile duct dilatation, beading, extrahepatic bile duct stenosis, wall enhancement and thickening. The most common MRI features of PSC concerning hepatic parenchyma are: rounded shape of the liver caused by hypertrophy of caudate lobe and left liver lobe, atrophy of the right lobe, enlargement of portal and/or portacaval lymph nodes, peripheral parenchymal inflammation, wedge-shaped confluent fibrosis, heterogeneity of the liver parenchyma, periportal oedema, cirrhosis with indirect signs of portal hypertension such as splenomegaly, ascites and collateral vasculature.
Highlights
Bile duct anatomyThe bile ducts are a number of tube-like structures that carry bile from the liver to the duodenum
Primary sclerosing cholangitis (PSC) is a chronic liver disease in which there are inflammation and scarring of the bile ducts leading to fibrosis, destruction and narrowing of the bile ducts, resulting in cholestasis
This paper presents current and brief review concerning magnetic resonance imaging of the primary sclerosing cholangitis
Summary
Julia Tuchalska-Czuroń*1, Aldona Wybraniec-Zaręba, Gabriela Półtorak-Szymczak, Mariusz Furmanek, Jerzy Walecki, Katarzyna Sklinda. Primary sclerosing cholangitis (PSC) is a chronic liver disease in which there are inflammation and scarring of the bile ducts leading to fibrosis, destruction and narrowing of the bile ducts, resulting in cholestasis. To make a diagnosis of PSC it is necessary to exclude secondary causes of sclerosing cholangitis. The most common MRI features of PSC concerning hepatic parenchyma are: rounded shape of the liver caused by hypertrophy of caudate lobe and left liver lobe, atrophy of the right lobe, enlargement of portal and/or portacaval lymph nodes, peripheral parenchymal inflammation, wedge-shaped confluent fibrosis, heterogeneity of the liver parenchyma, periportal oedema, cirrhosis with indirect signs of portal hypertension such as splenomegaly, ascites and collateral vasculature. Pierwotne stwardniające zapalenie dróg żółciowych jest przewlekłą chorobą wątroby, w której dochodzi do procesu zapalnego i bliznowacenia w obrębie dróg żółciowych, co prowadzi do ich włóknienia, destrukcji i zwężeń, skutkujących cholestazą. W obrazowaniu metodą rezonansu magnetycznego, u pacjentów z pierwotnym stwardniającym zapaleniem dróg żółciowych obserwuje się: odcinkowe poszerzenia i zwężenia dróg żółciowych ("obraz korali"), pogrubienie i wzmocnienie kontrastowe ścian dróg żółciowych, zaokrąglony obrys wątroby spowodowany powiększeniem płatów lewego i ogoniastego, atrofia płata prawego, powiększenie węzłów chłonnych okolicy żyły wrotnej i żyły głównej dolnej, obwodowo widoczne cechy zapalenia w obrębie miąższu, zlewające się obszary włóknienia klinowatego kształtu, niejednorodność miąższu, obrzęk okołowrotny, marskość wątroby z pośrednimi objawami nadciśnienia wrotnego, takimi jak powiększenie śledziony, wodobrzusze i naczynia krążenia obocznego
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