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Radiological patterns of secondary sclerosing cholangitis in patients after lung transplantation

 Hye Jin Kim  ;  Mi-Suk Park  ;  Jin Woo Son  ;  Kyunghwa Han  ;  Jei Hee Lee  ;  Jai Keun Kim  ;  Hyo Chae Paik 
 ABDOMINAL RADIOLOGY, Vol.44(4) : 1361-1366, 2019 
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CT ;  Lung transplantation ; MRCP ;  Secondary sclerosing cholangitis
PURPOSE: The purpose of this study was to investigate the radiological patterns of secondary sclerosing cholangitis (SSC) following lung transplantation. METHODS: Fifty-five patients underwent abdominopelvic CT before and after lung transplantation for end stage pulmonary disease. Nine patients underwent MR cholangiopancreatography (MRCP). The radiological patterns of biliary abnormalities (location, bile duct dilatation with stricture, beaded appearance, and biliary casts/sludge), laboratory data (serum total bilirubin and alkaline phosphatase), and patient survival rates were evaluated. SSC was diagnosed when there were newly developed biliary abnormalities with cholestasis after lung transplantation. Potential perioperative risk factors pertaining to SSC were analyzed. Patient survival rates with or without SSC were compared. RESULTS: Six of the 55 patients showed imaging and laboratory findings of SSC after lung transplantation. Multifocal dilatation and stricture involved the intrahepatic (6 of 6, 100%), hilar (4 of 6, 66.7%), and extrahepatic bile duct (1 of 6, 16.7%). On CT, the lesions presented as multifocal small cyst-like lesions along the bile duct course. On MRCP, the lesions showed beaded appearance with mild duct dilatation. Preoperative mechanical ventilation and bilateral lung transplantation were associated with SSC (p < 0.05). The median survival of patients with SSC was 4.6 months. CONCLUSION: Lung transplantation can induce SSC similar to SSC in critically ill patients, and result in worse clinical outcomes than in patients without SSC. Multifocal small cyst-like lesions along the intrahepatic bile duct on CT and beaded appearance on MRCP are suggestive findings of SSC in patients with cholestasis after lung transplantation.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
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