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Imaging: EUS and IDUS

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IgG4-Related Sclerosing Cholangitis
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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.

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References

  1. 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.

    Article  CAS  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. Hyodo N, Hyodo T. Ultrasonographic evaluation in patients with autoimmune-related pancreatitis. J Gastroenterol. 2003;38(12):1155–61.

    Article  PubMed  Google Scholar 

  4. Dietrich CF, Hirche TO, Ott M, Ignee A. Real-time tissue elastography in the diagnosis of autoimmune pancreatitis. Endoscopy. 2009;41(8):718–20.

    Article  CAS  PubMed  Google Scholar 

  5. Hocke M, Ignee A, Dietrich CF. Contrast-enhanced endoscopic ultrasound in the diagnosis of autoimmune pancreatitis. Endoscopy. 2011;43(2):163–5.

    Article  CAS  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed  Google Scholar 

  13. Moon SH, Kim MH. The role of endoscopy in the diagnosis of autoimmune pancreatitis. Gastrointest Endosc. 2012;76(3):645–56.

    Article  PubMed  Google Scholar 

  14. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. Kanno A, Masamune A, Shimosegawa T. Endoscopic approaches for the diagnosis of autoimmune pancreatitis. Dig Endosc. 2015;27(2):250–8.

    Article  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

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Correspondence to Itaru Naitoh .

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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

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  • DOI: https://doi.org/10.1007/978-981-10-4548-6_11

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-4547-9

  • Online ISBN: 978-981-10-4548-6

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