To study diagnostic efficacy of ultrasound and magnetic resonance cholangiopancreatography in obstructive jaundice

Abstract

Background and Objective: Ultrasonography (??USG) and magnetic resonance cholangiopancreatography (??MRCP) are noninvasive modalities for evaluation of patients with obstructive jaundice. USG is widely available and less expensive compared to MRCP. But the value of USG is limited in obese patients and distal CBD evaluation due to poor window caused by bowel gas. With this knowledge, we planned to assess the diagnostic efficacy of USG and MRCP in detecting the level and cause of obstructive jaundice considering the gold standard being the final diagnosis made at surgery/Endoscopic retrograde cholangiopancreatography (ERCP). Settings and Design: Prospective observational study. Material and Methods: The study was conducted in the department of Radio Diagnosis, SVIMS, over a period of 18 ?months from March 2018–July 2019. This study includes thirty-seven consecutive patients who were referred to the department of Radiodiagnosis with the clinical suspicion of obstructive jaundice and elevated serum bilirubin levels. USG followed by MRCP were done in all the patients. Results: Of the thirty-seven patients with obstructive jaundice, twenty-nine patients had benign while eight patients had malignant etiology. For diagnosing the cause of obstructive jaundice, MRCP has a diagnostic accuracy of 97.2% and USG has a diagnostic accuracy of 86.4%. The sensitivity of MRCP is greater than USG in diagnosing the cause of obstructive jaundice. In diagnosing the level of obstruction, MRCP had an accuracy of 100%, while USG 81%. Conclusion: As MRCP has more diagnostic accuracy compared to ultrasound in detecting the level and cause of obstruction in cases of obstructive jaundice, USG may be considered as an initial screening test and MRCP for definitive treatment planning. The limitation of the study is the small sample size.