Abstract
EUS is an important procedure for the differential diagnosis of type 1 autoimmune pancreatitis (AIP) from other pancreatic diseases because IgG4-SC is often associated with type 1 AIP. Bile duct wall thickening is considered the EUS finding of IgG4-SC with type 1 AIP. Cholangiocarcinoma (CCA) and primary sclerosing cholangitis (PSC) are important diagnoses that should be differentiated from IgG4-SC. IDUS findings of non-stricture bile duct lesions are different between IgG4-SC and CCA. The thickening of the bile duct wall in non-stricture lesion is the most characteristic IDUS finding of IgG4-SC. The IDUS findings of stricture lesions are also different between IgG4-SC and PSC. IDUS is a useful modality for differentiating IgG4-SC from CCA and PSC, as the details of bile duct wall thickening are easily observable.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tanaka A, Tazuma S, Okazaki K, Nakazawa T, Inui K, Chiba T, et al. Clinical features, response to treatment, and outcomes of IgG4-related sclerosing cholangitis. Clin Gastroenterol Hepatol. 2017;15(6):920–6 e3.
Hoki N, Mizuno N, Sawaki A, Tajika M, Takayama R, Shimizu Y, et al. Diagnosis of autoimmune pancreatitis using endoscopic ultrasonography. J Gastroenterol. 2009;44(2):154–9.
Hyodo N, Hyodo T. Ultrasonographic evaluation in patients with autoimmune-related pancreatitis. J Gastroenterol. 2003;38(12):1155–61.
Dietrich CF, Hirche TO, Ott M, Ignee A. Real-time tissue elastography in the diagnosis of autoimmune pancreatitis. Endoscopy. 2009;41(8):718–20.
Hocke M, Ignee A, Dietrich CF. Contrast-enhanced endoscopic ultrasound in the diagnosis of autoimmune pancreatitis. Endoscopy. 2011;43(2):163–5.
Imazu H, Kanazawa K, Mori N, Ikeda K, Kakutani H, Sumiyama K, et al. Novel quantitative perfusion analysis with contrast-enhanced harmonic EUS for differentiation of autoimmune pancreatitis from pancreatic carcinoma. Scand J Gastroenterol. 2012;47(7):853–60.
Iwashita T, Yasuda I, Doi S, Ando N, Nakashima M, Adachi S, et al. Use of samples from endoscopic ultrasound-guided 19-gauge fine-needle aspiration in diagnosis of autoimmune pancreatitis. Clin Gastroenterol Hepatol. 2012;10(3):316–22.
Kanno A, Ishida K, Hamada S, Fujishima F, Unno J, Kume K, et al. Diagnosis of autoimmune pancreatitis by EUS-FNA by using a 22-gauge needle based on the International Consensus Diagnostic Criteria. Gastrointest Endosc. 2012;76(3):594–602.
Ohara H, Okazaki K, Tsubouchi H, Inui K, Kawa S, Kamisawa T, et al. Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012. J Hepatobiliary Pancreat Sci. 2012;19(5):536–42.
Tamada K, Tomiyama T, Oohashi A, Aizawa T, Nishizono T, Wada S, et al. Bile duct wall thickness measured by intraductal US in patients who have not undergone previous biliary drainage. Gastrointest Endosc. 1999;49(2):199–203.
Naitoh I, Nakazawa T, Ohara H, Ando T, Hayashi K, Tanaka H, et al. Endoscopic transpapillary intraductal ultrasonography and biopsy in the diagnosis of IgG4-related sclerosing cholangitis. J Gastroenterol. 2009;44(11):1147–55.
Kubota K, Kato S, Uchiyama T, Watanabe S, Nozaki Y, Fujita K, et al. Discrimination between sclerosing cholangitis-associated autoimmune pancreatitis and primary sclerosing cholangitis, cancer using intraductal ultrasonography. Dig Endosc. 2011;23(1):10–6.
Moon SH, Kim MH. The role of endoscopy in the diagnosis of autoimmune pancreatitis. Gastrointest Endosc. 2012;76(3):645–56.
Tabata T, Kamisawa T, Hara S, Kuruma S, Chiba K, Kuwata G, et al. Differentiating immunoglobulin g4-related sclerosing cholangitis from hilar cholangiocarcinoma. Gut Liver. 2013;7(2):234–8.
Kamisawa T, Ohara H, Kim MH, Kanno A, Okazaki K, Fujita N. Role of endoscopy in the diagnosis of autoimmune pancreatitis and immunoglobulin G4-related sclerosing cholangitis. Dig Endosc. 2014;26(5):627–35.
Kanno A, Masamune A, Shimosegawa T. Endoscopic approaches for the diagnosis of autoimmune pancreatitis. Dig Endosc. 2015;27(2):250–8.
Hirano K, Tada M, Isayama H, Yamamoto K, Mizuno S, Yagioka H, et al. Endoscopic evaluation of factors contributing to intrapancreatic biliary stricture in autoimmune pancreatitis. Gastrointest Endosc. 2010;71(1):85–90.
Naitoh I, Nakazawa T, Hayashi K, Miyabe K, Shimizu S, Kondo H, et al. Comparison of intraductal ultrasonography findings between primary sclerosing cholangitis and IgG4-related sclerosing cholangitis. J Gastroenterol Hepatol. 2015;30(6):1104–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Science+Business Media Singapore
About this chapter
Cite this chapter
Naitoh, I., Nakazawa, T., Ohara, H., Joh, T. (2019). Imaging: EUS and IDUS. In: Kamisawa, T., Kim, MH. (eds) IgG4-Related Sclerosing Cholangitis. Springer, Singapore. https://doi.org/10.1007/978-981-10-4548-6_11
Download citation
DOI: https://doi.org/10.1007/978-981-10-4548-6_11
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-4547-9
Online ISBN: 978-981-10-4548-6
eBook Packages: MedicineMedicine (R0)