Primary sclerosing cholangitis other imaging findings

ERCP was considered the gold standard for diagnosis of primary sclerosing cholangitis, because it allows visualization of the biliary tree. However, MRCP is now preferred because of its non-invasive nature. Findings on these imaging modalities include alternating areas of strictures and dilatations of the intrahepatic and extra hepatic bile ducts.

ERCP has been regarded as the gold standard for diagnosis because it allows good visualization of the biliary system and the pancreas. However, MRCP is currently preferred due to its noninvasive nature.^[1] Common findings include:^[2]

• Multiple segmental strictures
• Biliary dilatation: may be present in ~85% of cases
• Biliary diverticula
• Mural irregularities
• Distortion of the biliary tree due to associated cirrhosis

MRCP is preferred over ERCP due to several reasons, which include:^[1][3][4][5]

• Non-invasive nature
• No use of radiation
• No need for antibiotic prophylaxis
• Cost-effectiveness
  

Imaging findings on MRCP are similar to those seen on ERCP.

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