THE SIGNIFICANCE OF MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP) IN THE DETECTION OF SUSPECTED CHOLEDOCHOLITHIASIS.

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) is a radiation-free test that can be performed quickly and does not expose patients to ionizing radiation or iodinated contrast material. The present study is intended to evaluate the role of MRCP in the detection of Common Bile Duct (CBD) stones in patients with suspected choledocholithiasis. Thi Materials and Methods: s prospective study included 64 patients with suspected choledocholithiasis which was based on clinical evaluation and biochemical or ultrasonographic examination. MRCP was done in all patients. All presenting patients underwent open surgery after proper investigation. CBD exploration was performed in all patients, either due to the presence of palpable stones or due to the presence of dilated CBD (≥8 mm). Demonstration of CBD stones intra-operatively was considered the gold standard' for their presence, dened as stones visualized and extracted or attempted for extraction during surgical CBD exploration. Results: Intraoperatively, 45 (70.3%) out of 64 patients had cholelithiasis. 55 (85.93%) out of 64 patients had dilated CBDs. In 43 (67.18%) out of 64 patients, choledocholithiasis was detected intraoperatively. The sensitivity, specicity, and positive and negative predictive value of ultrasonography in detecting CBD stones in the present study were found to be 65.11%, 61.9%, 77.77% and 46.43% respectively. The sensitivity, specicity, positive predictive value and negative predictive value of MRCP in the diagnosis of CBD stones in the present study were 95.35%, 90.47%, 95.35% and 90.48% respectively. MRCP is a non–invasive and uncomplicated investigation w Conclusion: ith high sensitivity, specicity, and positive and negative predictive values for the detection of CBD stones. Hence MRCP is advised in all cases with a suspicion of CBD stones, where facilities and expertise are available.