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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2021

01-12-2021 | Ultrasound

Biliary inflammation scoring for immunoglobulin G4-related sclerosing cholangitis: an endoscopic approach with endoscopic ultrasound

Authors: Yunlu Feng, Shengyu Zhang, Zehui Zheng, Xi Wu, Tao Guo, Qingwei Jiang, Qiang Wang, Dongsheng Wu, Aiming Yang

Published in: Surgical Endoscopy | Issue 12/2021

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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.
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Metadata
Title
Biliary inflammation scoring for immunoglobulin G4-related sclerosing cholangitis: an endoscopic approach with endoscopic ultrasound
Authors
Yunlu Feng
Shengyu Zhang
Zehui Zheng
Xi Wu
Tao Guo
Qingwei Jiang
Qiang Wang
Dongsheng Wu
Aiming Yang
Publication date
01-12-2021

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