Igravemagnetic Resonance Cholangiography in the evaluation of early stage primary sclerosing cholangitis

Abstract

SUMMARY
Background:The purpose of our study was to evaluate the
MR Cholangiographic findings of early stage primary
sclerosing cholangitis (PSC). Method:The patients were
examined with half fourier – single – shot turbo spin – echo
(HASTE), breath hold MR Cholangiography (MRC) using
a 1T Siemens Expert Plus Scanner. Axial T2 – Weighted
images were also obtained from all patients. We examined
32 patients with a cholestatic biochemical profile positive
for primary sclerosing cholangitis. The patients were
divided into two groups according the degree of the
abnormality of the values of the biochemical data. A third
group of 20 men and 5 women with normal biochemical
profile also were examined. Results: The first group
comprised 11 patients with mild disturbance of biochemical
profile showing a mild increase in signal intensity on T2WI
in liver parenchyma and haziness of the margins of the
intrahepatic bile ducts, due to inflammation, at MRC
cholangiography. The second group comprised 21 patients
with more stable increase of the biochemical profile. MRC
findings were haziness of the bile duct margins due to
inflammation and areas with dilatation of bile duct branches
due to stenosis from fibrosis. From the third group, we
found a mild increase in signal intensity on T2WI in the
liver parenchyma and haziness of the margins of the intirhepatic bile duct in 2 men with normal laboratory data.
Conclusion: This study suggests that MRC can be used for
the detection of early stage primary sclerosing cholangitis,
but it has low specificity in the characterization of this
disease. Although the method has low specificity, it is the
method of choice to evaluate this disease, if findings are
combined with positive laboratory data.
Key words: Bile ducts diseases, MR Cholangiography,
Cholangitis