Classifications of Primary Sclerosing Cholangitis on Cholangiography (Li-Yeng and Goldberg, 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

Strictures	Caliber	Arborization	Type
multiple	normal caliber to minimal dilatation	NA	I
multiple	saccular dilatations	decreased	II
NA	NA	severe pruning; only central branches fill despite adequate filling pressures	III

 

where:

• 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

 

Stenosis	Luminal Irregularities	Type
none	slight irregularities in contour	I
segmental	NA	II
stenosis over most of length	NA	III
NA	very irregular; diverticulum-like outpouchings	IV

 

where:

• 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.