[X-ray diagnosis of primary sclerosing cholangitis]. / Rentgenodiagnostika pervichnogo skleroziruiushchego kholangita.

Primary sclerosing cholangitis (PSC) should be regarded as a disease of the bile tracts which is difficult to diagnose rather than a rare disease. Combined radiodiagnostic investigation in the preoperative period is of great importance. Direct methods of an induced contrast study of the biliferous system (transcutaneous transhepatic cholangiography, endoscopic retrograde pancreatocholangiography) play a major role in the diagnosis of PSC. The authors present 11 cases, describing in detail x-ray semiotics of various sites of PSC and its differential diagnosis with similar diseases.

[Difficulties in the differential x-ray diagnosis of choledocholithiasis]. / Trudnosti differentsial'noi rentgenodiagnostiki kholedokholitiaza.

The authors consider some difficulties in the roentgenological interpretation of the filling defect in the biliary tracts revealed by a direct contrast study using the TTC or ERCG methods. The greatest difficulties are observed in the presence of the parietal defect that can be determined by an undisplaceable concrement, a small polypoid cancer of the duct and metastases to the lymph nodes, the lesser omentum along the common bile and hepatic ducts. To differentiate between these diseases one should bear in mind a degree of outlining the filling defect with a contrast medium, the presence of a constricted area below the defect, local tenderness, and bile infectiousness. The authors also consider a problem of how to interpret the symptom of a "snake mouth" or a "concave lens" which (depending on its cause) can be either transient (in a large concrement) or stable (in an exophytic tumor, completely occluding the duct).

[Hepatoportal sclerosis--special variant of liver cirrhosis]. / Gepatoportal'nyi skleroz--osobyi variant fibroza pecheni.

The clinical, functional, x-ray and morphological manifestations of hepatoportal sclerosis have been studied. It is assumed that involvement of the intrahepatic branches of the portal vein of the diffuse fibrosis type underlies hepatoportal sclerosis, a condition of unestablished etiology. Differential diagnosis should be made with the portal-hypertension pattern of congenital liver fibrosis and, according to the clinical manifestations, with liver cirrhosis.