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Erschienen in: European Radiology 11/2012

01.11.2012 | Hepatobiliary-Pancreas

Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT, endoscopic retrograde cholangiography and MR cholangiography

verfasst von: Jin Hee Kim, Jae Ho Byun, So Jung Lee, Seong Ho Park, Hyoung Jung Kim, Seung Soo Lee, Myung-Hwan Kim, Jihun Kim, Moon-Gyu Lee

Erschienen in: European Radiology | Ausgabe 11/2012

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Abstract

Objectives

To compare findings at dynamic computed tomography (CT), endoscopic retrograde cholangiography (ERC) and magnetic resonance cholangiography (MRC) in patients with sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and periductal infiltrating cancer in the common bile duct (CBD), and to evaluate the diagnostic performance of ERC and MRC in differentiating between the two diseases.

Methods

Bile duct changes at dynamic CT, ERC and MRC were compared in 58 patients with SC-AIP and CBD involvement and 93 patients with periductal infiltrating CBD cancer. Two radiologists rated their confidence in differentiating between the two diseases and the diagnostic performances of ERC and MRC were compared.

Results

At CT, SC-AIP was more frequently associated with intrapancreatic CBD involvement, thinner CBD walls, concentric wall thickening, smooth outer margins, and lower degrees of upstream ductal dilatation and contrast enhancement (P ≤ 0.05) than CBD cancer. At ERC and MRC, SC-AIP was more frequently associated with smooth margins, gradual and symmetric narrowing, multifocal involvement and hourglass appearance (P ≤ 0.027) than CBD cancer. MRC showed good diagnostic performance comparable to ERC.

Conclusions

Dynamic CT, ERC and MRC can be helpful in distinguishing SC-AIP from periductal infiltrating CBD cancer. MRC may be a useful diagnostic alternative to ERC in differentiating between the two diseases.

Key Points

SC-AIP often mimics periductal infiltrating ductal cancer.
Imaging findings of SC-AIP and periductal infiltrating CBD cancer can be similar.
Dynamic CT, ERC and MRC help differentiate between these two diseases.
MRC may be a useful diagnostic alternative to ERC.
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Metadaten
Titel
Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT, endoscopic retrograde cholangiography and MR cholangiography
verfasst von
Jin Hee Kim
Jae Ho Byun
So Jung Lee
Seong Ho Park
Hyoung Jung Kim
Seung Soo Lee
Myung-Hwan Kim
Jihun Kim
Moon-Gyu Lee
Publikationsdatum
01.11.2012
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 11/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2507-1

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