Comparative study of multidetector computed tomography and magnetic resonance cholangiopancreatography in obstructive jaundice

Abstract

Background: Accurate diagnosis of the cause is crucial in the management of obstructive jaundice. Multidetector computed tomography (MDCT) and magnetic resonance cholangiopancreatography (MRCP) play the pivotal roles in the diagnosis. Objective: The objective of this study is to evaluate the diagnostic accuracy of MDCT in determining the level and cause of biliary obstruction in patients with obstructive jaundice and correlates MDCT findings with that of MRCP. Materials and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis of a tertiary hospital in Manipur after obtaining the Institutional Ethical Committee approval. Fifty-seven patients with obstructive jaundice, age ranging 20–80 years, were subjected to MDCT and MRCP. Final definite diagnosis was made from operative or histopathological findings. Data and findings of MDCT and MRCP were correlated and statistically analyzed. Results: Maximum numbers of cases were seen to occur in the fourth to sixth decades. The female-to-male ratio was 1.4:1. Both MDCT and MRCP could correctly determine the level of obstruction in all the cases. The most common level of obstruction was at the suprapancreatic level. The most common cause of obstruction was choledocholithiasis (45.61%). Benign causes constituted 68% and malignant causes constituted 32%. MDCT could correctly determine the cause in 85.96% of cases, compared to 75.44% by MRCP. Kappa statistics showed fair agreement between MDCT and MRCP in diagnosing the cause of biliary obstruction. MDCT showed comparable sensitivity, specificity, and positive and negative predictive value, in diagnosing the causes of obstruction. Conclusion: Overall performance of the MDCT was comparable or better than that of MRCP.