{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:19:48Z","timestamp":1791256788931,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T00:00:00Z","timestamp":1637452800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>Magnetic resonance imaging with magnetic resonance cholangiopancreatography (MRI\u2010MRCP) in primary sclerosing cholangitis (PSC) is currently based on qualitative assessment and has high interobserver variability. We investigated the utility and performance of quantitative metrics derived from a three\u2010dimensional biliary analysis tool in adult patients with PSC. MRI\u2010MRCP, blood\u2010based biomarkers, and FibroScan were prospectively performed in 80 participants with large\u2010duct PSC and 20 healthy participants. Quantitative analysis was performed using MRCP+ (Perspectum Ltd., United Kingdom), and qualitative reads were performed by radiologists. Inter\u2010reader agreements were compared. Patients were classified into high risk or low risk for disease progression, using Mayo risk score (MRS), Amsterdam\u2010Oxford model (AOM), upper limit of normal (ULN) alkaline phosphatase (ALP), disease distribution, and presence of dominant stricture. Performance of noninvasive tools was assessed using binomial logistic regressions and receiver operating characteristic curve analyses. Quantitative biliary metrics performed well to distinguish abnormal from normal bile ducts (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001). Interobserver agreements for MRCP+ dilatation metrics (intraclass correlation coefficient,\u00a00.90\u20100.96) were superior to modified Amsterdam intrahepatic stricture severity score (\u03ba\u00a0=\u00a00.74) and Anali score (\u03ba\u00a0=\u00a00.38). MRCP+ intrahepatic dilatation severity showed excellent performance to classify patients into high\u2010risk and low\u2010risk groups, using predictors of disease severity as the reference (MRS, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.0001; AOM, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0017; 2.2 \u00d7 ULN ALP, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0007; 1.5 \u00d7 ULN ALP, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0225; extrahepatic disease, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0331; dominant stricture, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.0019). MRCP+ intrahepatic dilatation severity was an independent predictor of MRS &gt;0 (odds ratio, 31.3; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.035) in the multivariate analysis. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Intrahepatic biliary dilatation severity calculated using MRCP+ is elevated in patients with high\u2010risk PSC and may be used as an adjunct for risk stratification in PSC. This exploratory study has provided the groundwork for examining the utility of novel quantitative biliary metrics in multicenter studies.<\/jats:p>","DOI":"10.1002\/hep4.1860","type":"journal-article","created":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T15:54:55Z","timestamp":1637510095000},"page":"795-808","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":30,"title":["A Quantitative Magnetic Resonance Cholangiopancreatography Metric of Intrahepatic Biliary Dilatation Severity Detects High\u2010Risk Primary Sclerosing Cholangitis"],"prefix":"10.1097","volume":"6","author":[{"given":"Emmanuel A.","family":"Selvaraj","sequence":"first","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research,Radcliffe Department of Medicine,University of Oxford,Oxford,United Kingdom"},{"name":"Translational Gastroenterology Unit,Nuffield Department of Medicine,University of Oxford,Oxford,United Kingdom"},{"name":"National Institute for Health Research Oxford Biomedical Research Centre,University of Oxford,Oxford,United Kingdom"},{"name":"Oxford University Hospitals National Health Service Foundation Trust,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Ba\u2010Ssalamah","sequence":"additional","affiliation":[{"name":"Medical University of Vienna,Department of Biomedical Imaging and Image\u2010Guided Therapy,General Hospital of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Poetter\u2010Lang","sequence":"additional","affiliation":[{"name":"Medical University of Vienna,Department of Biomedical Imaging and Image\u2010Guided Therapy,General Hospital of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard R.","family":"Ridgway","sequence":"additional","affiliation":[{"name":"Perspectum Ltd.,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Michael","family":"Brady","sequence":"additional","affiliation":[{"name":"Perspectum Ltd.,Oxford,United Kingdom"},{"name":"Department of Oncology,Medical Sciences Division,University of Oxford,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Collier","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology Unit,Nuffield Department of Medicine,University of Oxford,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L.","family":"Culver","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology Unit,Nuffield Department of Medicine,University of Oxford,Oxford,United Kingdom"},{"name":"National Institute for Health Research Oxford Biomedical Research Centre,University of Oxford,Oxford,United Kingdom"},{"name":"Oxford University Hospitals National Health Service Foundation Trust,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bailey","sequence":"additional","affiliation":[{"name":"Translational Gastroenterology Unit,Nuffield Department of Medicine,University of Oxford,Oxford,United Kingdom"},{"name":"National Institute for Health Research Oxford Biomedical Research Centre,University of Oxford,Oxford,United Kingdom"},{"name":"Oxford University Hospitals National Health Service Foundation Trust,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pavlides","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research,Radcliffe Department of Medicine,University of Oxford,Oxford,United Kingdom"},{"name":"Translational Gastroenterology Unit,Nuffield Department of Medicine,University of Oxford,Oxford,United Kingdom"},{"name":"National Institute for Health Research Oxford Biomedical Research Centre,University of Oxford,Oxford,United Kingdom"},{"name":"Oxford University Hospitals National Health Service Foundation Trust,Oxford,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,11,21]]},"reference":[{"key":"hep41860-bib-0001-20241115","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1016\/S0140-6736(13)60096-3","article-title":"Primary sclerosing cholangitis","volume":"382","year":"2013","journal-title":"Lancet"},{"key":"hep41860-bib-0002-20241115","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1056\/NEJMra1506330","article-title":"Primary sclerosing cholangitis","volume":"375","year":"2016","journal-title":"N Engl J Med"},{"key":"hep41860-bib-0003-20241115","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1002\/hep.28128","article-title":"Risk stratification in autoimmune cholestatic liver diseases: opportunities for clinicians and 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