Prevalence, clinical features, and impact of radiological PSC detected by MRCP in newly-diagnosed adult UC and CD patients in a prospective, population-based inception cohort in Copenhagen, Denmark (2021–2023), with a median follow-up of 2.0 years.
Among 389 IBD patients who underwent MRCP, 8.0% had radiological PSC (UC: 6.6%; CD: 10.2%) and an additional 1.8% had PSC-like lesions — a combined prevalence of 9.8%. Nearly half (48.4%) had no abnormal liver biochemistry. PSC was linked to extensive colitis (12.3% vs. 4.3%, p=0.02), higher IBD-related hospitalization (41.9% vs. 23.4%, p=0.03), and more frequent biological therapy use (38.7% vs. 21.4%, p=0.03).
- Only 73.8% of eligible patients underwent MRCP, introducing potential selection bias. - Median follow-up of 2.0 years is too short to assess long-term clinical significance of radiological PSC findings. - No cost-effectiveness analysis was performed to support routine MRCP screening at IBD diagnosis.
About 1 in 10 newly-diagnosed IBD patients had radiological PSC on MRCP, most without abnormal liver tests — suggesting standard biochemistry alone misses a significant proportion of PSC. MRCP at IBD diagnosis may be beneficial, but routine screening cannot yet be recommended without long-term outcome data and cost-effectiveness evidence.
