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

作者：Kim Jin Hee; Byun Jae Ho^*; Lee So Jung; Park Seong Ho; Kim Hyoung Jung; Lee Seung Soo; Kim Myung Hwan; Kim Jihun; Lee Moon Gyu

来源：European Radiology, 2012, 22(11): 2502-2513.

DOI：10.1007/s00330-012-2507-1

• Sclerosing cholangitis with autoimmune pancreatitis
• Periductal infiltrating common bile duct cancer
• Dynamic computed tomography
• Endoscopic retrograde cholangiography
• Magnetic resonance cholangiography

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. %26lt;br%26gt;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. %26lt;br%26gt;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 a parts per thousand currency signaEuro parts per thousand 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 a parts per thousand currency signaEuro parts per thousand 0.027) than CBD cancer. MRC showed good diagnostic performance comparable to ERC. %26lt;br%26gt;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. %26lt;br%26gt;aEuro cent SC-AIP often mimics periductal infiltrating ductal cancer. %26lt;br%26gt;aEuro cent Imaging findings of SC-AIP and periductal infiltrating CBD cancer can be similar. %26lt;br%26gt;aEuro cent Dynamic CT, ERC and MRC help differentiate between these two diseases. %26lt;br%26gt;aEuro cent MRC may be a useful diagnostic alternative to ERC.

• 出版日期2012-11