Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2018
Systematic screening for primary sclerosing cholangitis with magnetic resonance cholangiography in inflammatory bowel disease.
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Belle Arthur, Laurent Valérie, Pouillon Lieven, Baumann Cédric, Orry Xavier, Lopez Anthony, Rousseau Hélène, Bronowicki Jean-Pierre, Peyrin-Biroulet Laurent
Аннотация
BACKGROUND: Primary sclerosing cholangitis (PSC) is a major concern in inflammatory bowel disease (IBD).
AIMS: Evaluating the use of magnetic resonance cholangiography (MRC) as a screening tool for PSC in IBD patients.
METHODS: A single-center cohort study investigating systematic MRC to assess PSC in IBD patients with (cohort 1) and without (cohort 2) liver function tests (LFTs) abnormality, combined with a retrospective analysis of MRCs in a control group of non-IBD patients with abnormal LFTs (cohort 3).
RESULTS: In total, 420 patients (cohort 1: n = 203, cohort 2: n = 30, cohort 3: n = 187) underwent imaging. MRC was classified 'abnormal' in 49/203 (24.1%) patients in cohort 1, in 1/30 (3.3%) patients in cohort 2, and in 66/187 (35.3%) patients in cohort 3 (p < 0.004 for all comparisons). PSC was diagnosed in 20/203 (9.9%) patients in cohort 1, in 1/30 (3.3%) patients in cohort 2, and in 13/187 (7.0%) patients in cohort 3 (p = 0.44). Gamma-glutamyl transpeptidase was the only independent factor predicting the diagnosis of PSC in IBD (OR 1.8, 95% CI 1.3-2.5, p = 0.001).
CONCLUSIONS: MRC revealed PSC in one tenth of IBD patients with abnormal LFTs and should be systematically performed in IBD patients with abnormal LFTs, especially if gamma-glutamyl transpeptidase level is elevated.
AIMS: Evaluating the use of magnetic resonance cholangiography (MRC) as a screening tool for PSC in IBD patients.
METHODS: A single-center cohort study investigating systematic MRC to assess PSC in IBD patients with (cohort 1) and without (cohort 2) liver function tests (LFTs) abnormality, combined with a retrospective analysis of MRCs in a control group of non-IBD patients with abnormal LFTs (cohort 3).
RESULTS: In total, 420 patients (cohort 1: n = 203, cohort 2: n = 30, cohort 3: n = 187) underwent imaging. MRC was classified 'abnormal' in 49/203 (24.1%) patients in cohort 1, in 1/30 (3.3%) patients in cohort 2, and in 66/187 (35.3%) patients in cohort 3 (p < 0.004 for all comparisons). PSC was diagnosed in 20/203 (9.9%) patients in cohort 1, in 1/30 (3.3%) patients in cohort 2, and in 13/187 (7.0%) patients in cohort 3 (p = 0.44). Gamma-glutamyl transpeptidase was the only independent factor predicting the diagnosis of PSC in IBD (OR 1.8, 95% CI 1.3-2.5, p = 0.001).
CONCLUSIONS: MRC revealed PSC in one tenth of IBD patients with abnormal LFTs and should be systematically performed in IBD patients with abnormal LFTs, especially if gamma-glutamyl transpeptidase level is elevated.