Lena M. Hallberg1, Annika Bergquist2, Nils Albiin1
1Radiology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; 2Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Insitutet, Stockholm, Sweden
Cholangiocarcinoma is a well known threat to patients with primary sclerosing cholangitis (PSC). Although, early diagnosis is crucial for curative surgical treatment, it is difficult to differentiate malignant strictures from benign. We wanted to see if excretion hepatobiliary contrast was inhibited in affected segments, as a sign of malignancy. Therefore, six patients with PSC and a histopathologically confirmed cholangiocarcinoma , were examined in a 1.5 T MRI and Gd-BOPTA i.v. administered. In five of these patients there was no sign of excretion in affected segments. Thus, inhibited hepatobiliary excretion is a sign of cholangiocarcinoma in patients with primary sclerosing cholangitis.