Evaluation of obstructive jaundice using magnetic resonance cholangiopancreatography (mrcp)

Background: Obstructive jaundice is one of the most frequent and grave form of hepatobiliary
disease. It can pose problems in diagnosis and management, particularly intrahepatic cholestasis.
Aim: Toevaluate the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography(MRCP)
in studying the cause of obstructive jaundice, diagnosing anddifferentiating benign from malignant
lesions and to compare it with USG findingsalong with histopathological and surgical correlation.
Material and Method: This is a prospective study conducted at Ribat university hospital over a
period starting from April 2015 to April 2016. 80 patients who were referred from department of
surgery and medicine with strong clinical suspicion of biliary obstruction and altered LFT were
enrolled in the study. Initial Ultrasonography (USG) evaluation was followed by MRCP,
Histopathological diagnosis, surgical findings (as applicable) were considered as reference.
Result:On ultrasound 49/80 patients were diagnosed with the actual cause of obstructive jaundice. On
the other hand 57/80 patients were diagnosed with actual cause of obstructive jaundice on
MRCP.Majority of cases of biliary obstruction were due to Choledocholithiasis (31%) followed by
strictures(12%), then cholangiocarcinoma (18%) then GB mass (6%),then choledochal cyst (3%), and
pancreatic pathology (6%).
Conclusion: Ultrasound is a good screening method but it is less accurate for diagnosing the distal
CBD obstruction. MRCP on the other hand has the high sensitivity for diagnosing the cause and
extent of biliary obstruction and hence should be the modality of choice for all the patients presenting
with obstructive jaundice.