Li-Yeng and Goldberg developed a classification for intra and extrahepatic changes of primary sclerosing cholangitis (PSC) as seen on cholangiography. This was later modified slightly by Majoie et al.
Parameters for the intrahepatic bile ducts:
(1) strictures of intrahepatic bile ducts
(2) caliber of the intrahepatic bile ducts
(3) arborization of intrahepatic bile ducts into the left and right hepatic lobes
normal caliber to minimal dilatation
severe pruning; only central branches fill despite adequate filling pressures
• The above classification is that of Majoie et al, based on that of Li-Yeng and Goldberg.
• Type I of Majoie et al is a combination of Li-Yeng and Goldberg Types I and II (Type I = minor irregularities in contour, local narrowing, prestenotic dilatation; Type II = alternating threadlike narrowing with normal or near normal areas). These 2 types were difficult to separate in practice.
• Type II for Majoie et al is Type III for Li-Yeng and Goldberg. Type III of Majoie is Type IV for Li-Yeng and Goldberg.
Parameters for extrahepatic bile ducts:
(4) stenosis of the extrahepatic bile ducts (strictures)
(5) luminal irregularities of the extrahepatic bile ducts
slight irregularities in contour
stenosis over most of length
very irregular; diverticulum-like outpouchings
• Stenosis for extrahepatic ducts is similar to strictures for intrahepatic.
• Saccular dilatations of intrahepatic ducts may be smaller versions of the diverticulum-like outpouchings in the extrahepatic ducts.
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Specialty: Gastroenterology, Immunology/Rheumatology