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    Hepaticolithiasis is observed in viagra femenina gel 11% to 21% of cases. 18-1). Increasing experience with magnetic resonance cholangiography (MRC) suggests that this non-invasive diagnostic approach is accurate in more than 80% of cases diagnosed as PSC compared with invasive cholangiography (Fig. Evaluation of the biliary tree in PSC by endoscopic or percutaneous transhepatic cholangiography may reveal diffuse stricturing of both intrahepatic and extrahepatic ducts with saccular dilatation of intervening areas. The presence of a dominant stricture should raise the question of cholangiocarcinoma as a complication of PSC.

    Exclusive intrahepatic and hilar involvement occurs in only 20% of patients. These abnormalities result in the characteristic beads-on-a-string appearance seen with PSC. Including diffuse stricturing and beading of intrahepatic and extrahepatic bile ducts, figure 20-1.  Retrograde cholangiogram exhibiting classic features of PSC.

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