OBJECTIVE: The purpose of
this study was to evaluate the spectrum of MR imaging features of primary
sclerosing cholangitis. MATERIALS AND METHODS: A retrospective review was
performed of MR imaging findings including MR cholangiography and multiphasic
contrast-enhanced dynamic sequences in 22 patients with primary sclerosing
cholangitis. MR imaging analysis included abnormalities of intra- and extrahepatic
bile ducts, abnormalities of liver parenchyma, changes in liver morphology,
and lymphadenopathy. RESULTS: Abnormal findings of bile ducts were seen
in all 22 patients; the most common finding was intrahepatic bile duct
dilatation (77%), followed by intrahepatic bile duct stenosis (64%), extrahepatic
bile duct wall enhancement (67%), extrahepatic bile duct wall thickening
(50%), extrahepatic bile duct stenosis (50%), and intrahepatic bile duct
beading (36%). Increased enhancement of the liver parenchyma on dynamic
arterial-phase images, predominantly in the peripheral areas of the liver,
was identified in 56% of patients. Other findings included periportal lymphadenopathy
(77%), periportal high signal intensity on T2-weighted images (68%), hypertrophy
of the caudate lobe (68%), and abnormal hyperintensity of the liver parenchyma
on T1-weighted images (23%). CONCLUSION: On MR imaging, primary sclerosing
cholangitis showed several characteristic features, including bile duct
abnormalities and increased enhancement of the liver parenchyma. MR cholangiography
and contrast-enhanced dynamic MR techniques are useful for revealing intra-
and extrahepatic signs of primary sclerosing cholangitis.
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