Theme |
Primary Sclerosing Cholangitis |
Title |
Ultrasonographic Findings in Primary Sclerosing Cholangitis |
Author |
Toshio Tsuyuguchi |
First Department of Medicine, Chiba University School of Medicine |
Author |
Hiromitsu Saisho |
First Department of Medicine, Chiba University School of Medicine |
[ Summary ] |
Primary sclerosing cholangitis (PSC) is a rare disease of unknown origin that involves the intrahepatic or extrahepatic biliary system or both. Most early stage patients are asymptomatic and present only with raised liver enzymes. Sonography is less invasive and is useful for detecting PSC. It shows mural thickening of the common bile duct. Recently, intraductal ultrasonography (IDUS) with catheter based ultrasound probes has become available. It shows high-resolution images of the bile duct and surrounding structures. Thickening of the inner low echoic layer of the bile duct wall was seen not only at the stricture site but also at non-stricture sites with PSC. However, IDUS cannot distinguish between benign and malignant strictures. If the tumor invades neighboring organs, such as the pancreas, a diagnosis of malignant strictures may be made with confidence. Further studies and improvement in catheter design are required. |