Quantitative Magnetic Resonance Cholangiopancreatography Scoring and Its Predictive Value for Outcomes in Adults with Primary Sclerosing Cholangitis

Primary sclerosing cholangitis (PSC) is an immune-mediated disease that has an unfavorable prognosis and needs a liver transplant (LT). The aim of this paper was to show the usefulness of the Majoie classification on magnetic resonance cholangiopancreatography (MRCP) images in assessing the prognosi...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-08, Vol.13 (15), p.4548
Main Authors: Mandea, Matei, Iacob, Speranta Maria, Grasu, Mugur Cristian, Anghel, Cristian, Iacob, Razvan Andrei, Ghioca, Mihaela Corina, Gheorghe, Cristian, Gheorghe, Liliana Simona
Format: Article
Language:English
Subjects:
Analysis
Bile ducts
Biomarkers
Biopsy
Care and treatment
Cholangitis
Classification
Clinical significance
Diagnosis
Endoscopy
Ethics
Gallbladder diseases
Health aspects
Inflammatory bowel disease
Liver diseases
Liver transplants
Magnetic resonance imaging
Medical prognosis
Patients
Pediatrics
Prognosis
Software
Citations: Items that this one cites
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Summary:Primary sclerosing cholangitis (PSC) is an immune-mediated disease that has an unfavorable prognosis and needs a liver transplant (LT). The aim of this paper was to show the usefulness of the Majoie classification on magnetic resonance cholangiopancreatography (MRCP) images in assessing the prognosis in adult patients with PSC. Our work presents a retrospective monocentric study performed on 64 adult patients with PSC of the large bile ducts. Two radiologists evaluated the MRCP of diagnosis and calculated MRCP scores using the Majoie classification. Liver-related outcome (LT or liver-related death) was marked as a primary endpoint. Univariate analysis showed that patients with more severe lesions (sum score of intrahepatic and extrahepatic ducts > 3) had a lower age at diagnosis, of 37.2 years, complicated with liver cirrhosis (53.1% of patients) and recurrent cholangitis (28.1%) < 0.05, without significant differences in mortality, association with IBD or LT. Concordance analysis between MRCP prognostic scores and progression to a PSC-related event showed a moderate relationship (c-statistic 0.662), and a good AUROC was observed for the UKPSC score (0.893) and the MRS (0.936). In the study, we observed a good correlation between the imaging scores based on the Majoie classification and the evolution of the patients. These scores were outperformed by the UKPSC, MRS, and PREsTo clinical models. Their utility was best in predicting recurrent cholangitis.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13154548