Comparison of sclerosing cholangitis with autoimmune pancreatitis and infiltrative extrahepatic cholangiocarcinoma: multidetector-row computed tomography findings

• Published in: Japanese Journal of Radiology Vol. 28; no. 3; pp. 205 - 213
• Main Authors: Arikawa, Shunji, Uchida, Masafumi, Kunou, Yukiko, Uozumi, Jun, Abe, Toshi, Hayabuchi, Naofumi, Ishida, Yusuke, Kaji, Ryohei, Okabe, Yoshinobu, Murotani, Kenta
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.04.2010; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Autoimmune Diseases - complications; Autoimmune Diseases - diagnostic imaging; Bile Duct Neoplasms - diagnostic imaging; Bile Ducts, Extrahepatic; Cholangiocarcinoma - diagnostic imaging; Cholangitis, Sclerosing - complications; Cholangitis, Sclerosing - diagnostic imaging; Female; Humans; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Original Article; Pancreatitis, Chronic - complications; Pancreatitis, Chronic - diagnostic imaging; Radiology; Radiotherapy; Sensitivity and Specificity; Tomography, X-Ray Computed; Infiltrative extrahepatic cholangiocarcinoma (IEC); Sclerosing cholangitis with autoimmune pancreatitis (SC-AIP); Multidetector-row computed tomography (MDCT)
• ISSN: 1867-1071; 1862-5274; 1867-108X
• DOI: 10.1007/s11604-009-0410-8

Purpose The aim of this study was to compare multidetector-row computed tomography (MDCT) findings between cases of sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) and infiltrative extrahepatic cholangiocarcinoma (IEC). Materials and methods We retrospectively assessed MDCT findings from 16 IEC cases and 13 SC-AIP cases. MDCT findings were analyzed with regard to location, length, wall thickness, contour, stricture wall enhancement pattern, proximal duct diameter, and the presence of diffuse concentric thickening in the proximal duct and gallbladder wall thickness. Results Stricture length, stricture wall thickness, and proximal duct diameter were significantly smaller for SC-AIP than for IEC: 19.3 ± 8.7 vs. 31.8 ± 12.0 mm ( P = 0.004), 2.1 ± 1.3 vs. 4.1 ± 1.3 mm ( P < 0.001), and 9.2 ± 3.9 vs. 13.3 ± 5.0 mm ( P = 0.012), respectively. SC-AIP was correlated with stricture location in both the intrapancreatic and hilar hepatic bile ducts, concentric stricture contour ( P < 0.001), and diffuse concentric thickening of the proximal bile duct ( P = 0.010). Overall values of sensitivity, specificity, and accuracy used to distinguish between SC-AIP and IEC for stricture wall thickness of <3.0 mm and concentric contour were 76.9%, 93.8%, and 86.2%, respectively, and 100%, 87.5%, 93.1%, respectively. Conclusion Concentric contour and stricture wall thicknesses of <3.0 mm may help distinguish between SC-AIP and IEC.