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Singh A, Mann HS, Thukral CL, et al. Diagnostic Accuracy of MRCP as Compared to Ultrasound/CT in Patients with Obstructive Jaundice. J Clin Diagn Res. 2014;8(3):103-7doi: 10.7860/JCDR/2014/8149.4120.
Singh, A., Mann, H. S., Thukral, C. L., & Singh, N. R. (2014). Diagnostic Accuracy of MRCP as Compared to Ultrasound/CT in Patients with Obstructive Jaundice. Journal of clinical and diagnostic research : JCDR, 8(3), 103-7. https://doi.org/10.7860/JCDR/2014/8149.4120
Singh, Amandeep, et al. "Diagnostic Accuracy of MRCP as Compared to Ultrasound/CT in Patients with Obstructive Jaundice." Journal of clinical and diagnostic research : JCDR vol. 8,3 (2014): 103-7. doi: https://doi.org/10.7860/JCDR/2014/8149.4120
Singh A, Mann HS, Thukral CL, Singh NR. Diagnostic Accuracy of MRCP as Compared to Ultrasound/CT in Patients with Obstructive Jaundice. J Clin Diagn Res. 2014 Mar;8(3):103-7. doi: 10.7860/JCDR/2014/8149.4120. Epub 2014 Mar 15. PMID: 24783094; PMCID: PMC4003596.
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J Clin Diagn Res. 2014 Mar;8(3):103-7. doi: 10.7860/JCDR/2014/8149.4120. Epub 2014 Mar 15.

Diagnostic Accuracy of MRCP as Compared to Ultrasound/CT in Patients with Obstructive Jaundice.

Journal of clinical and diagnostic research : JCDR

Amandeep Singh, Harkaran Singh Mann, Chuni Lal Thukral, Neeti Rajan Singh

Affiliations

  1. Assistant Professor, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical, Sciences and Research , Vallah, Sri Amritsar, India .
  2. P. G. Resident, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research , Sri Amritsar, India .
  3. Professor and Head, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical, Sciences and Research , Vallah, Sri Amritsar, India .
  4. Professor, Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research , Sri Amritsar, India .

PMID: 24783094 PMCID: PMC4003596 DOI: 10.7860/JCDR/2014/8149.4120

Abstract

BACKGROUND: The expanding spectrum of therapeutic options for patients with surgical jaundice makes it necessary for the radiologist to precisely assess the etiology, location, level and extent of disease.

AIM: To compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) with Ultrasound and Computed Tomography (CT) in evaluation of patients with obstructive jaundice taking direct cholangiographies (ERCP and PTC), hystologic tests and anatomo-pathological findings after surgical intervention as gold standard.

SETTINGS AND DESIGN: This prospective study included 50 patients who were referred to the radiology department with clinical features of biliary obstructive disease.

MATERIALS AND METHODS: Initial ultrasonography (USG) evaluation was followed by Computed tomography (CT) and Magnetic Resonance Cholangiopancreatography (MRCP);however in cases of benign pathologies where USG findings were unequivocal Computed tomography (CT )was not done to avoid unnecessary radiation exposure. The results were read by radiologists blinded to other imaging findings. The characteristic Endoscopic Retrograde Cholangiopancreatography (ERCP) features/ histopathological diagnosis / surgical findings (as applicable) were considered as final.

RESULTS: Diagnostic accuracy of MRCP (98%) in the diagnosis of benign and malignant diseases was relatively high (98% and 98%) as compared to CT (82.86% and 91.43% in benign and malignant respectively) and USG (88% and 88%). In the diagnosis of benign diseases MRCP was 100% sensitive compared to ultrasound (80.77%), which was more sensitive than CT scan (54.55%).In the diagnosis of malignant diseases, MRCP was more sensitive (95.83%) as compared to CT scan (91.67%), which was more sensitive than ultrasonography (79.17%).

CONCLUSION: Ultrasound as a screening modality is useful to confirm or exclude biliary dilatation and to choose patients for MRCP examination. MRCP is an important non invasive imaging investigation in the pre operative evaluation of patients with obstructive jaundice.

Keywords: CBD; Cholangiocarcinoma; Choledocholithiasis; MRCP; Obstructive jaundice; Periampullary carcinoma; Stricture

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