Endoscopic ultrasound elastography as a method for screening the patients with suspected primary sclerosing cholangitis

Abstract

Objectives: Currently, magnetic resonance cholangiography is being used for establishing the diagnosis of primary sclerosing cholangitis, whereas endoscopic retrograde cholangiography is reserved for therapeutic interventions. The aim of this study was to determine the role of endoscopic ultrasound elastography in the detection of inflammatory and fibrotic lesions of the common bile duct.

Methods: Linear endoscopic ultrasound elastography of the common bile duct was performed in 41 patients. The patients were divided into two groups: disease group (20 patients with both, primary sclerosing cholangitis and inflammatory bowel disease) and control group (21 patients). Main outcome measurements were diameter, wall thickness and wall qualitative Elasto Score of the common bile duct.

Results: The disease group consisted of nine females and 11 males, whereas the control group consisted of 13 females and eight males, with no sex differences observed (chi = 0.6, d.f. = 1, P = 0.443). There was no significant difference in the diameter of common bile duct between the studied groups: 4.67+/-1.83 mm in the disease group and 5.88+/-2.47 mm in controls (t = -1.77, d.f. = 39, P = 0.085). Hard or mixed Elasto Score was found in 16 patients and four controls, being significantly different compared with the soft Elasto Score found in four patients and 17 controls (chi = 1.8, d.f. = 1, P<0.001). A significant difference was observed in the common bile duct wall thickness: 0.89+/-0.59 mm in the disease group and 0.39+/-0.14 mm in controls (t = 3.75, d.f. = 39, P<0.001).

Conclusion: Endoscopic ultrasound elastography might be a useful noninvasive method in diagnosing primary sclerosing cholangitis.