Primary sclerosing cholangitis: CT findings.

Computed tomographic (CT) findings in six cases of primary sclerosing cholangitis (PSC) are described. Computed tomographic findings correlate with cholangiographic findings and show ductal dilatations and distortions in the porta hepatis and in the liver parenchyma. The CT features are round, oval, or irregular, sometimes branching, focal dilatations of the biliary tree. When subtle, irregular dilatations of the intrahepatic biliary tree are observed, the presumptive diagnosis of sclerosing cholangitis can be made from CT. Confirmation of this diagnosis with cholangiography is essential in all patients. Recognition of this entity by a noninvasive method will avoid long delays in diagnosis and will expedite the use of the more definitive procedures such as endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, or liver biopsy.