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Abstract：
BACKGROUND: The CT findings of cirrhosis caused by primary sclerosing cholangitis (PSC) differ from cryptogenic cirrhosis. PSC could become complicated with biliary cirrhosis and cholangiocarcinoma. This study aimed at augmenting the information on the role of the three-phasic-abdominopelvic CT scan in PSC.
METHODS: A total of 185 CT scans were retrospectively reviewed, including 100 patients with cryptogenic cirrhosis and 85 patients with PSC-cirrhosis. Different morphologic criteria were compared, including segmental atrophy/hypertrophy, hepatic contour, portal-hypertension, perihilar lymphadenopathy, biliary tree dilatation, gallbladder appearance. Inflammatory-bowel-disease (IBD) and cholangiocarcinoma frequency, presence of perihilar lymph nodes (LNs), and their size during end-stage PSC cirrhosis are investigated.
RESULTS: Six findings occur more frequently with PSC than those diagnosed with cryptogenic cirrhosis. Modified caudate/right lobe (m-CRL) ratio >0.73, moderate and severe lobulated liver contour, lateral left lobe atrophy, over distended gallbladder (GB), biliary tree dilatation and wall thickening, and LN sizes were higher in PSC patients as compared to cryptogenic cirrhosis (P < 0.005). Ascites and portosystemic collateral formations were significant in cryptogenic cirrhosis compared to PSC patients (P < 0.005). Cholangiocarcinoma frequency in PSC patients was 14.7%, and the frequency of inflammatory bowel disease (IBD) was 57.6%. Further, 22.4% of the patients were diagnosed with IBD and PSC simultaneously. The LN number and size in PSC patients were not different between those with or without cholangiocarcinoma.
CONCLUSIONS: Using three-phasic CT scans and PSC characteristics could be considered as an additional suggestion besides pathology measures. Diagnosis of PSC based on histological findings could be a last resort due to its invasive essence and specific characteristics of PSC in imaging.
METHODS: A total of 185 CT scans were retrospectively reviewed, including 100 patients with cryptogenic cirrhosis and 85 patients with PSC-cirrhosis. Different morphologic criteria were compared, including segmental atrophy/hypertrophy, hepatic contour, portal-hypertension, perihilar lymphadenopathy, biliary tree dilatation, gallbladder appearance. Inflammatory-bowel-disease (IBD) and cholangiocarcinoma frequency, presence of perihilar lymph nodes (LNs), and their size during end-stage PSC cirrhosis are investigated.
RESULTS: Six findings occur more frequently with PSC than those diagnosed with cryptogenic cirrhosis. Modified caudate/right lobe (m-CRL) ratio >0.73, moderate and severe lobulated liver contour, lateral left lobe atrophy, over distended gallbladder (GB), biliary tree dilatation and wall thickening, and LN sizes were higher in PSC patients as compared to cryptogenic cirrhosis (P < 0.005). Ascites and portosystemic collateral formations were significant in cryptogenic cirrhosis compared to PSC patients (P < 0.005). Cholangiocarcinoma frequency in PSC patients was 14.7%, and the frequency of inflammatory bowel disease (IBD) was 57.6%. Further, 22.4% of the patients were diagnosed with IBD and PSC simultaneously. The LN number and size in PSC patients were not different between those with or without cholangiocarcinoma.
CONCLUSIONS: Using three-phasic CT scans and PSC characteristics could be considered as an additional suggestion besides pathology measures. Diagnosis of PSC based on histological findings could be a last resort due to its invasive essence and specific characteristics of PSC in imaging.
摘要：
背景：原发性硬化性胆管炎（PSC）引起的肝硬化的CT表现与隐源性肝硬化不同。PSC可并发胆汁性肝硬化和胆管癌。这项研究旨在增加有关三相腹骨盆CT扫描在PSC中的作用的信息。
方法：回顾性分析共185例CT扫描，包括100例隐源性肝硬化和85例PSC肝硬化患者。比较了不同的形态学标准，包括节段性萎缩/肥大，肝轮廓,门静脉高压症,肺门周围淋巴结病，胆道树扩张，胆囊外观。炎症性肠病（IBD）和胆管癌的频率，存在肺门周围淋巴结（LN），和他们的大小在终末期PSC肝硬化进行调查。
结果：6个发现发生于PSC的频率高于诊断为隐源性肝硬化的患者。改良尾状/右叶（m-CRL）比值>0.73，中重度肝叶轮廓，左叶外侧萎缩，胆囊过度扩张(GB)，胆道树扩张和壁增厚，与隐源性肝硬化相比，PSC患者的LN大小更高（P<0.005）。与PSC患者相比，隐源性肝硬化的腹水和门体侧支形成显着（P<0.005）。PSC患者胆管癌发生率为14.7%,炎症性肠病（IBD）的发病率为57.6%。Further,22.4%的患者同时诊断为IBD和PSC。有或没有胆管癌的PSC患者的LN数量和大小没有差异。
结论：使用三相CT扫描和PSC特征可以被认为是除病理测量外的额外建议。基于组织学发现的PSC诊断可能是最后的手段，因为其侵入性本质和PSC在影像学上的特定特征。
方法：回顾性分析共185例CT扫描，包括100例隐源性肝硬化和85例PSC肝硬化患者。比较了不同的形态学标准，包括节段性萎缩/肥大，肝轮廓,门静脉高压症,肺门周围淋巴结病，胆道树扩张，胆囊外观。炎症性肠病（IBD）和胆管癌的频率，存在肺门周围淋巴结（LN），和他们的大小在终末期PSC肝硬化进行调查。
结果：6个发现发生于PSC的频率高于诊断为隐源性肝硬化的患者。改良尾状/右叶（m-CRL）比值>0.73，中重度肝叶轮廓，左叶外侧萎缩，胆囊过度扩张(GB)，胆道树扩张和壁增厚，与隐源性肝硬化相比，PSC患者的LN大小更高（P<0.005）。与PSC患者相比，隐源性肝硬化的腹水和门体侧支形成显着（P<0.005）。PSC患者胆管癌发生率为14.7%,炎症性肠病（IBD）的发病率为57.6%。Further,22.4%的患者同时诊断为IBD和PSC。有或没有胆管癌的PSC患者的LN数量和大小没有差异。
结论：使用三相CT扫描和PSC特征可以被认为是除病理测量外的额外建议。基于组织学发现的PSC诊断可能是最后的手段，因为其侵入性本质和PSC在影像学上的特定特征。
