Role of Magnetic Resonance Cholangiopancreatography in Patients with Pancreatico-Biliary Diseases

Abstract

Introduction: Advancements in Magnetic Resonance Cholangiopancreatography (MRCP) technique like development of new pulse sequences and strong magnetic field provided significantly better imaging of pancreatico-biliary diseases with good contrast resolution without any significant artifacts. There is no use of intravenous contrast and it is free of any type of ionizing radiation. As compared to Endoscopic Retrograde Cholangiopancreatography (ERCP) which can only depict the intraluminal pathologies and associated with major complications like pancreatitis, sepsis and even death, MRCP can depict intra-ductal as well as extra ductal pathologies & also it is not associated with any major complication. Aim: The purpose of the present study is to assess diagnostic accuracy of the MRCP in patients with pancreatico-biliary diseases. Materials and Method: A prospective cross-sectional study which included 50 patients with pancreatico biliary diseases who were referred to our department for MRCP and who further underwent ERCP and/or Surgery. Results: Our study consisted of patients of both sexes (14 female & 36 male) with age group ranging from 12 to 84yrs. In the present study the overall sensitivity and specificity of MRCP in diagnosing pancreatico biliary diseases were 97.96% and 100% respectively with a positive predictive value of 100% and negative predictive value of 87.43%. Conclusion: MRCP has high diagnostic accuracy and is almost equivalent to ERCP in diagnosing abnormalities of intrahepatic biliary radicles and common bile duct (CBD). MRCP should be the primary investigation of choice for diagnosis of pancreatico-biliary diseases to plan course of management. ERCP should be reserved for the cases where intervention is required.