- 70% patients have history of inflammatory bowel disease – ulcerative colitis
- Multiple segments of stricture involving intra- and/or extra-hepatic ducts
- Bile duct wall thickening at sites of structuring
- Small diverticula-like outpouchings
- Cholangiocarcinoma in 10% cases
- Cholangiography: multifocal strictures, areas of distension, pruning of ducts, areas of ductal isolation
- CT-IVC and MRCP: thickened biliary epithelium shows post contrast enhancement.
- Areas of atrophy and hypertrophy within liver
- Bile duct stones (10% cases)
- Cholangiocarcinoma: progressive duct dilatation proximal to stricture or if nodule is identified
Khoshpouri, Pegah, et al. “Imaging features of primary sclerosing cholangitis: from diagnosis to liver transplant follow-up.” Radiographics 39.7 (2019): 1938-1964.
Vitellas, Kenneth M., et al. “Radiologic manifestations of sclerosing cholangitis with emphasis on MR cholangiopancreatography.” Radiographics 20.4 (2000): 959-975.