Comparison of intraductal ultrasonography findings between primary sclerosing cholangitis and IgG4-related sclerosing cholangitis.

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.

• 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)
• Copyright: © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Chemical References

• Immunoglobulin G

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