Primary sclerosing cholangitis (PSC) is a rare chronic liver disease that leads to stricturing of bile ducts and a heterogeneous distribution of hepatic fibrosis. Despite the success of MR cholangiopancreaticogram and liver biopsy for the detection of PSC, they do not correlate with the severity of disease. Currently, there is no accurate diagnostic reference standard for monitoring the disease activity in PSC which limits patient management. Tomoelastography has the potential to quantify heterogeneity in PSC-related hepatic fibrosis using a normalized standard deviation index as a new biomarker besides overall stiffness.
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