Role of Magnetic Resonance Cholangiopancreatography (MRCP) in Evaluation of Pancreaticobiliary Pathologies and Correlation with Ultrasound Findings

Abstract

Background- In this prospective study, we evaluated the role of magnetic resonance cholangiopancreatography (MRCP) as an imaging modality for identification and characterization of various pancreaticobiliary pathologies and to correlate MRCP findings with ultrasound (USG) findings. Methodology–This study was carried out as an observational study in Department of Radiodiagnosis, GMC Bhopal, for a study period of 20 months on patients suspected with pancreaticobiliary pathologies reporting for ultrasound examination. MRCP was performed following Ultrasound imaging (USG) with subsequent comparison of findings. Results- The sensitivity, specificity and diagnostic accuracy of ultrasound in detection of CBD dilatation were 86.21%. 100% and 92% respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of ultrasound in detection of intrahepatic biliary radicle (IHBR) dilatation was 81.97%. 97.44%. 98.04%. 77.55% and 88% respectively. The sensitivity of USG for identification of benign lesions was 93.55% whereas that for malignant lesions was 96.15%. Overall, diagnostic accuracy of USG for identification of benign and malignant lesions was 84% and 87% respectively. Conclusion– Although abdominal ultrasound continues to serve as a screening tool for detection of pancreaticobiliary pathologies and allows for differentiation between surgical and non-surgical causes of obstructive jaundice, the in-depth characterization of lesions as provided by magnetic resonance imaging (MRI) with MRCP suggests that it serves as an indispensable adjunct to endoscopic retrograde cholangiopancreatography (ERCP). MRCP with MRI serves as an accurate and non-invasive, non-ionizing imaging method for evaluation of biliary anatomy and pathology especially in cases of obese patients where ultrasound results are compromised.