Question 1423
{"accessible":false,"alternatives":[{"id":7091,"text":"ascending cholangitis"},{"id":7092,"text":"Cushing syndrome"},{"id":7093,"text":"glycogen storage disease type I"},{"id":7094,"text":"hepatocellular carcinoma"},{"id":7095,"text":"primary sclerosing cholangitis"}],"archived":false,"correctAlternativeId":7095,"explanation":"\u003cp\u003e\u003cstrong\u003ePrimary sclerosing cholangitis\u003c/strong\u003e\u0026nbsp;\u003cstrong\u003e(PSC)\u0026nbsp;\u003c/strong\u003eis an inflammatory condition of the bile ducts that leads to periductal fibrosis and\u0026nbsp;stricturing. In advanced stages of PSC\u0026nbsp;the strictures narrow the smallest branches of the biliary \"tree\" to the point that they are not visible on MRCP or ERCP -- only the larger \"branches\" of the bile duct are visible, leading to a \"pruned tree\" appearance.\u003c/p\u003e\u003cp\u003ePSC also often presents with biliary enhancement (67% of the time).\u003c/p\u003e","id":1423,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2039","nextQuestionPath":null,"relatedArticles":[{"id":7007,"title":"Primary sclerosing cholangitis","link":"/articles/primary-sclerosing-cholangitis?lang=us"},{"id":58600,"title":"Cushing syndrome","link":"/articles/cushing-syndrome?lang=us"},{"id":35490,"title":"Endoscopic retrograde cholangiopancreatography","link":"/articles/endoscopic-retrograde-cholangiopancreatography?lang=us"},{"id":7632,"title":"Glycogen storage disease","link":"/articles/glycogen-storage-disease?lang=us"},{"id":1442,"title":"Hepatocellular carcinoma","link":"/articles/hepatocellular-carcinoma?lang=us"},{"id":32557,"title":"Magnetic resonance cholangiopancreatography (MRCP)","link":"/articles/magnetic-resonance-cholangiopancreatography-mrcp-2?lang=us"},{"id":73176,"title":"Bile duct enhancement (differential)","link":"/articles/bile-duct-enhancement-differential?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eWhich one of these conditions may present with biliary enhancement and a \"pruned tree\" appearance of the bile ducts?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1423"}],"attemptsPercentages":[{"alternativeId":"7094","percentage":3},{"alternativeId":"7095","percentage":72},{"alternativeId":"7091","percentage":22},{"alternativeId":"7093","percentage":1},{"alternativeId":"7092","percentage":1}],"promptToLogin":false,"questionManager":false,"articleId":"acute-cholangitis"}