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, 25 (6), 644-658

Evolving Role of Magnetic Resonance Techniques in Primary Sclerosing Cholangitis


Evolving Role of Magnetic Resonance Techniques in Primary Sclerosing Cholangitis

Emmanuel A Selvaraj et al. World J Gastroenterol.


Development of non-invasive methods to risk-stratify patients and predict clinical endpoints have been identified as one of the key research priorities in primary sclerosing cholangitis (PSC). In addition to serum and histological biomarkers, there has been much recent interest in developing imaging biomarkers that can predict disease course and clinical outcomes in PSC. Magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) continue to play a central role in the diagnosis and follow-up of PSC patients. Magnetic resonance (MR) techniques have undergone significant advancement over the last three decades both in MR data acquisition and interpretation. The progression from a qualitative to quantitative approach in MR acquisition techniques and data interpretation, offers the opportunity for the development of objective and reproducible imaging biomarkers that can potentially be incorporated as an additional endpoint in clinical trials. This review article will discuss how the role of MR techniques have evolved over the last three decades from emerging as an alternative diagnostic tool to endoscopic retrograde cholangiopancreatography, to being instrumental in the ongoing search for imaging biomarker of disease stage, progression and prognosis in PSC.

Keywords: Diffusion magnetic resonance imaging; Endoscopic retrograde cholangiopancreatography; Magnetic resonance cholangiopancreatography; Magnetic resonance elastography; Magnetic resonance imaging; Primary sclerosing cholangitis.

Conflict of interest statement

Conflict-of-interest statement: Pavlides M is a shareholder for the company Perspectum Diagnostics and has applied for a patent for medical imaging. All other authors declare no conflicts of interest.


Figure 1
Figure 1
Magnetic resonance cholangiopancreatography annotating typical features of large-duct-primary sclerosing cholangitis. A: Common hepatic duct stricture (arrow) and intrahepatic duct beading (arrowheads); B: Dominant stricture (arrow) and dilated proximal intrahepatic ducts secondary to distal strictures (arrowheads); C: Area of non-filling of intrahepatic ducts indicating tight stricture (arrow) and common hepatic duct stricture (arrowhead); D: Pseudodiverticula.
Figure 2
Figure 2
Summary of complications resulting from disease progression in primary sclerosing cholangitis. PSC: Primary sclerosing cholangitis.
Figure 3
Figure 3
Magnetic resonance imaging progression risk score[69]. MRI: Magnetic resonance imaging.

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