Diagnostic Accuracy of Magnetic Resonance Cholangio-Pancreatography (MRCP) in Evaluating Obstructive Jaundice, Keeping Endoscopic Retrograde Cholangio-Pancreatography(ERCP) as Gold Standard

Abstract

Objective: To determine the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography in evaluating obstructive Jaundice, taking Endoscopic Retrograde Cholangiopancreatography as the gold standard.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Armed Forces Institute of Radiology and Imaging in collaboration with the Gastroenterology Department of Military Hospital, Rawalpindi Pakistan, from Jun to Dec 2019.
 Methodology: Ninety patients with a history of obstructive Jaundice referred to the Armed Forces Institute of Radiology and Imaging for Magnetic Resonance Cholangiopancreatography were included in the study. Magnetic Resonance Cholangiopancreatography was followed by Endoscopic Retrograde Cholangiopancreatography within 48 hours. Magnetic Resonance Cholangiopancreatography results were compared with Endoscopic Retrograde Cholangiopancreatography and diagnostic accuracy was calculated.
 Results: The mean age was 57.58±14.65 years. The study constituted 40 male (44.4%) and 50 female (55.6%) patients. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of Magnetic Resonance Cholangiopancreatography, keeping Endoscopic Retrograde Cholangiopancreatography as the gold standard, were calculated as 91.04%, 89.04%, 95.31%, 76.90% and 90.0%, respectively. The positive likelihood ratio was 7, while the negative likelihood ratio was 0.10.
 Conclusion: Magnetic Resonance Cholangiopancreatography is a non-invasive and safe investigation with excellent diagnostic accuracy in evaluating obstructive Jaundice. Thus, Magnetic Resonance Cholangiopancreatography may be an alternative to Endoscopic Retrograde Cholangiopancreatography, especially in cases without intervention or in pregnant females, as it is free from ionizing radiation.