Abstract | BACKGROUND AND AIM: Comparisons of intraductal ultrasonography (IDUS) findings between primary sclerosing cholangitis (PSC) and IgG4-related sclerosing cholangitis (IgG4-SC) have not been elucidated. We aimed to clarify the differences in transpapillary IDUS findings between PSC and IgG4-SC. METHODS: We retrospectively compared transpapillary IDUS findings between 15 patients with PSC and 35 patients with IgG4-SC between 2004 and 2014. RESULTS: IDUS findings of circular-asymmetric wall thickness, irregular inner margin, diverticulum-like outpouching, unclear outer margin, heterogeneous internal echo, and disappearance of three layers were significantly higher in PSC than in IgG4-SC (P < 0.001). Irregular inner margin, diverticulum-like outpouching, and disappearance of three layers were specific IDUS findings for PSC compared to IgG4-SC. Diverticulum-like outpouching on IDUS and endoscopic retrograde cholangiogram (ERC) was observed in 10 (67%) and five (33%) of 15 patients with PSC, respectively. However, based on IDUS and ERC, diverticulum-like outpouching was not observed in any patient with IgG4-SC. All five patients with diverticulum-like outpouching on ERC had diverticulum-like outpouching on IDUS, and five (50%) of 10 patients without diverticulum-like outpouching on ERC had diverticulum-like outpouching on IDUS. CONCLUSIONS: The IDUS findings differed between PSC and IgG4-SC. Irregular inner margin, diverticulum-like outpouching, and disappearance of three layers are specific IDUS findings for PSC compared to IgG4-SC. IDUS is a more useful procedure than ERC for the early detection of diverticulum-like outpouching.
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Authors | Itaru Naitoh, Takahiro Nakazawa, Kazuki Hayashi, Katsuyuki Miyabe, Shuya Shimizu, Hiromu Kondo, Yuji Nishi, Michihiro Yoshida, Shuichiro Umemura, Yasuki Hori, Akihisa Kato, Fumihiro Okumura, Hitoshi Sano, Hirotaka Ohara, Takashi Joh |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
Vol. 30
Issue 6
Pg. 1104-9
(Jun 2015)
ISSN: 1440-1746 [Electronic] Australia |
PMID | 25594435
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd. |
Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Bile Ducts
(diagnostic imaging)
- Biliary Tract Diseases
- Cholangiopancreatography, Endoscopic Retrograde
- Cholangitis, Sclerosing
(classification, diagnostic imaging, etiology)
- Diagnosis, Differential
- Diverticulum
- Female
- Humans
- Immunoglobulin G
- Male
- Middle Aged
- Retrospective Studies
- Ultrasonography, Interventional
(methods)
- Young Adult
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