Primary biliary tract malignancies: MRI spectrum and mimics with histopathological correlation

Pardeep K. Mittal, Courtney Coursey Moreno, Bobby Kalb, Ankush Mittal, Juan C. Camacho, Kiran Maddu, Hiroumi D. Kitajima, Brian C. Quigley, Nima Kokabi, William C. Small

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Contrast-enhanced magnetic resonance imaging and magnetic resonance cholangiopancreatography (MRCP), due to their excellent soft tissue contrasts, have become first-line noninvasive tests in the characterization and detection of both hepatic and pancreaticobiliary pathologies. MRCP is also helpful in detecting the level and cause of obstruction in patients presenting with jaundice. Cholangiocarcinoma (CCA) is the most common primary malignant tumor arising from the bile duct epithelium, with extrahepatic tumors presenting more often than with intrahepatic ones. However, the diagnosis and management of CCA is made more complex by a variety of malignant and benign conditions that resemble CCA, including hepatocellular carcinoma variants such as the fibrolamellar variant of hepatocellular carcinoma, cholangiocellular carcinoma, biliary metastases, hepatic inflammatory pseudotumor, lymphoepithelioma-like carcinoma, confluent fibrosis, primary sclerosis cholangitis, and the secondary sclerosing cholangitis complex. Consequently, knowledge of the underlying risk factors and imaging characteristics of these conditions is important in differentiating between neoplastic and non-neoplastic conditions in order to reach a definite diagnosis. Endoscopic retrograde cholangiopancreatography should be reserved for those patients who require intervention or biopsy for histopathological diagnosis.

Original languageEnglish (US)
Pages (from-to)1520-1557
Number of pages38
JournalAbdominal Imaging
Issue number6
StatePublished - Aug 12 2015


  • Cholangiocarcinoma (CCA)
  • Magnetic resonance imaging (MRI)
  • Primary sclerosing cholangitis (PSC)

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology


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