Comparative Study to Assess Diagnostic Reliability of Ultrasound and 3T-MRCP in Patient of Obstructive Jaundice

Abstract

Background: Evaluation of jaundice patients should include proper history and examination, laboratory investigation and imaging investigations (non invasive like Ultrasound (U\S), CT and MRI or invasive like ERCP and PTC). Aim of Study: The aim of this prospective study is to evaluate the diagnostic reliability of U\S and MRI-MRCP in patients of obstructive jaundice in clinical practice. Materials and Methods: This is a prospective study performed on 60 patients (31 male and 29 female) with an average age of 55.53 +/- 17.57 years presented with obstructive jaundice for whom abdominal ultrasound (U\S) and magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) on 3 Tesla was performed in the departments of radiology in Max super speciality teaching hospital, saket, Delhi, India from May 2012 to May 2013. The final diagnosis was achieved by endoscopic retrograde cholangiopancreatography (ERCP) and \or surgery and confirmed by histopathology. Results: The most common cause of obstructive jaundice in our study was common bile duct stones (51.65%) followed by tumors (33.3%) then benign strictures (10.0%), choledochal cyst (3.33%). In this study, MRI-MRCP could differentiate surgical from medical jaundice in all cases, while U\S could differentiate surgical from medical jaundice in 91.25% of cases. MRI-MRCP correctly defines the level of obstruction in all cases (100%). While U\S correctly define the level of obstruction in only 78% of the total cases. MRI-MRCP correctly suggests the most possible cause of obstruction in 96.25% of cases. While USG is correctly suggests the most possible cause in only 76.3%. Conclusion: So that USG as a screening modality is useful to confirm or exclude biliary dilatation & to choose patients for MRCP examination. MRI-MRCP is a useful non-invasive and essential method in the preoperative evaluation of patients with obstructive jaundice. In addition MRI-MRCP was superior to U\S or ERCP in studying the extent & staging of malignant lesions.