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Diagnostic ultrasound ( PDFDrive )

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FIG. 6.22 Primary Sclerosing Cholangitis. (A) Isoechoic inlammatory tissue causing obliteration of right and left hepatic ducts (short arrows)

with proximal dilation. (B) Dilated intrahepatic ducts “rat-tail” as they extend centrally toward the hepatic hilum. Note the hypoechoic ductal/

periductal tissue obstructing the central ducts (arrowheads). (C) Saccular diverticula (arrow) of the duct are occasionally seen presumably due to

distal obstruction. (D) Intraductal stones (short arrows) are seen, which often do not shadow. (E) and (F) Common bile duct wall thickening of

moderate and severe degrees, respectively. Note the extremely narrowed, anechoic central lumen with a inely serrated appearance. See also

Videos 6.5 and 6.6.

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