1. Biliary inflammation scoring for immunoglobulin G4-related sclerosing cholangitis: an endoscopic approach with endoscopic ultrasound.
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Feng, Yunlu, Zhang, Shengyu, Zheng, Zehui, Wu, Xi, Guo, Tao, Jiang, Qingwei, Wang, Qiang, Wu, Dongsheng, and Yang, Aiming
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CHOLANGITIS , *ENDOSCOPIC ultrasonography , *DIAGNOSIS , *DIFFERENTIAL diagnosis , *ENDOSCOPY , *ULTRASONIC imaging , *RESEARCH , *IMMUNOGLOBULINS , *INFLAMMATION , *BILE duct diseases , *RESEARCH funding , *BILE ducts ,BILE duct tumors - Abstract
Background and Aims: The differential diagnosis of immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) and cholangiocarcinoma (CC) remains a clinical challenge. Imaging modalities play critical roles in the diagnosis of IgG4-SC. The present study aimed to evaluate the differential diagnosis of IgG4-SC and CC based on images of endoscopic ultrasound (EUS).Methods: The biliary inflammation scoring (BIS) method for EUS was developed based on the comparison between images of IgG4-SC and that of cholangiocarcinoma (CC) and other acute or chronic cholangitis. In the BIS diagnostic phase, the EUS images from 66 IgG4-SC patients and 44 CC patients were blindly evaluated using the BIS methods.Results: The sensitivity, specificity, and accuracy of the newly established BIS in distinguishing IgG4-SC from CC were 86% [95% confidence interval (CI) 75-93%], 95% (95% CI 83-99%), and 90% (95% CI 83-94%), respectively.Conclusion: EUS should be considered to be added to the workup algorithm in patients with suspected IgG4-SC as a useful diagnostic procedure. BIS is a promising diagnostic method to discriminate IgG4-SC during the ongoing endoscopy. [ABSTRACT FROM AUTHOR]- Published
- 2021
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