Sonographic findings in ten cases of primary sclerosing cholangitis are described. Thickening of the extrahepatic bile ducts is the most common finding. Other features are intrahepatic duct wall thickening and mild irregular dilatation, hepatic parenchymal change and evidence of portal hypertension. Two patterns of hepatic parenchymal change are noted: a) diffuse liver change and, b) patchy areas of increased echogenicity. Dilatation of the extrahepatic bile ducts is uncommon. Recognition of these findings will lead to the use of the more definitive procedures such as endoscopic retrograde cholangiography and will avoid a delay in diagnosis. Copyright 1986, Wiley Blackwell. All rights reserved
