Primary sclerosing cholangitis

Case contributed by Chris O'Donnell
Diagnosis almost certain


Past history of ulcerative colitis, now abnormal liver function tests.

Patient Data

Age: 60 years
Gender: Male

Typical gross central stricturing of the ducts with proximal dilatation.

3D MRCP nicely shows gross stricturing centrally involving the right and left hepatic ducts with segmental and subsegmental involvement.

T1 post-contrast, early arterial phase, shows regional perfusion abnormalities.

Case Discussion

Primary sclerosing cholangitis is commonly seen in patients with ulcerative colitis. Should be differentiated from cholangiocarcinoma, especially on contrast imaging, by excluding the presence of a mass.

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