KUMJ | VOL. 19 | NO. 1 | ISSUE 73 | JAN.-MARCH, 2021
Role of Magnetic Resonance Cholangiopancreatography in the Evaluation of Obstructive Jaundice
Karki S, Phuyal A, Paudel RC, Bhandari A, Dahal MR
Abstract: Background
Magnetic Resonance Cholangiopancreatography is a reliable and highly sensitive
imaging modality in the diagnosis of Obstructive jaundice.
Objective
To evaluate the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography
as compared to Endoscopic Retrograde Cholangiopancreatography.
Method
A prospective, analytical study was conducted in the Department of Radiodiagnosis
and Imaging at Dhulikhel Hospital between October 2018 and December
2020. Altogether 100 patients of all ages with obstructive jaundice undergoing
Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde
Cholangiopancreatography were included. The causes of obstructive jaundice as
identified by Magnetic Resonance Cholangiopancreatography were compared to
that of Endoscopic Retrograde Cholangiopancreatography considering Endoscopic
Retrograde Cholangiopancreatography as gold standard for the diagnosis.
Result
Magnetic Resonance Cholangiopancreatography revealed choledocholithiasis in
60 (60%) patients, benign stricture – 14(14%), malignant stricture-11(11%), periampullary
carcinoma in 8(8%) and normal study in 4(4%) patients. Endoscopic
Retrograde Cholangiopancreatography showed choledocholithiasis in 59(59%)
patients, strictures (benign in 13%, malignant in 10%), ascariasis in 3(3%) and
normal findings in 5(5%) patients. The sensitivity, specificity, positive predictive value
and negative predictive value of Magnetic Resonance Cholangiopancreatography
in detecting choledocholithiasis were 96.6%, 92.3%, 95%, and 95%. The same
values for benign strictures were 92.3%, 97.7%, 85.7% and 98.9%, whereas those
for malignant strictures were 90.9%, 98.8%, 90.9% and 98.8%. All values were
100% for peri-ampullary carcinoma and ascariasis. Hence, Magnetic Resonance
Cholangiopancreatography showed good accuracy for detecting causes of obstructive
jaundice (p < 0.05) as compared to Endoscopic Retrograde Cholangiopancreatography.
Conclusion
Magnetic Resonance Cholangiopancreatography is an accurate, non-invasive
technique in evaluation of obstructive jaundice and offers similar diagnostic value
compared to Endoscopic Retrograde Cholangiopancreatography.
Keyword : Endoscopic retrograde, Magnetic resonance cholangiopancreatography, Obstructive jaundice
