PSC

Cholangiography is used in the initial diagnosis of the disease, when there are only subtle strictures and in patients known with PSC to look for new strictures that are suspicious for carcinoma.

On cholangiography we can see:

• Beading: alternating pattern of strictures and normal or slightly dilated ducts
• Pruned-tree: distal bile ducts are narrowed and difficult to see
• Mural irregularity: irregular luminal margin (best seen on the left in the extrahepatic duct)
• Diverticula: best seen in the next patient