Original Articles
Diagnostic accuracy of Ultrasonography& Magnetic resonance cholangiopancreatography in obstructive jaundice patients – A comparative study | |
Dr. Chandini Reang, Dr. Bithika Jamatia, Dr. Jaybrata Ray | |
Background and Objective: Obstructive jaundice is a common problem routinely seen in clinical practice. The diagnosis relies on proper history taking, clinical examination, laboratory investigations and different non invasive imaging modalities. Ultrasonography (USG) and magnetic resonance cholangiopancreatography (MRCP) are non-invasive modalities for evaluation of patients with obstructive jaundice. USG is widely available and cost effective modality 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, the aim of the study is to evaluate the diagnostic accuracy 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)/biopsy. Settings and Design: Comparative study. Material and Methods: The study was included 60 consecutive patients who were referred to the department of Radio-diagnosis with the clinical suspicion of obstructive jaundice and elevated serum bilirubin levels. USG followed by MRCP were done in all the patients and findings were correlated with per operative, biopsy and ERCP report to calculate the diagnostic performance. Results: Of the 60 patients with obstructive jaundice, thirty six patients had benign while twenty four patients had malignant etiology. Most common benign causes observed was choledocholithiasis (77.77%) and malignant cause was carcinoma gall bladder (33.33%). 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: The results of this study demonstrate MRCP has a high diagnostic accuracy, high sensitivity and moderate specificity compared to ultrasound in diagnosis of the level and cause of obstruction in obstructive jaundice patients. But USG may be considered as an initial screening test and MRCP for definitive treatment planning. |
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