Study of Obstructive Jaundice using US and MRI

Abstract

The aim of the current study was to study the obstructive jaundice using US and MRI; the study took place in Khartoum state centers include: Elamal elwatany diagnostic center, Khartoum diagnostic center, and Elnielin medical center during the period between Augusts to September 2012. The sample size was fifty patients were examined using U\S system with 3.5 MHz probe and MRI-MRCP, using echo Time in excess of 200 ms and repetition Time of more than 10 s are required, Field Of View 300 mm and slice thickness 1mm. Those examinations were performed using Philips 1.5 Tesla superconductive type with a useful aperture of 61 cm; and SIEMENS AG 20061.5 Tesla superconductive type. A body coil was used for the examination, peripheral pulse unit and respiratory compensator. The examinations were done by U\S using Toshiba, Aloka,Tran’s abdominal convex probe 3.5MGz. MRI-MRCP images were reviewed at the diagnostic workstation and on hard copy films by 2 expert radiologists, and U\S images diagnosed by two sonologist. The results after analysis by EXCELL program, showed that: The obstructive jaundice OJ was predominant among female relative to male as 54% and 46% respectively and as well it is predominant among the age group of 60-69 years old. And the common etiological factors detected by US was: the CBD stone (14%), Cancer (16%), hydatid cyst (4%), chole cyst (2%) while U\S could not reach a specific diagnosis in Benign strictures however MRI could detect most of the etiological factors as follows: the common bile duct CBD stone (36%), Cancer (38%), stricture (14%), hydatid cyst (2%), chole cyst (2%). The study showed that MRI has ability to diagnose 96% of etiological factors of obstructive jaundice relative to US which only diagnose 36% of cases. Also MRI-MRCP was capable in defining the site of obstruction in all cases (100%) as follows: portal hepatic (12%), proximal CBD (10%) and distal CBD (78%). While U\S was only capable in defining the site of obstruction in 88% of cases as follows: portal hepatic (12%), proximal CBD (6%) and distal CBD (70%). The etiological factors of OJ at Dist CBD using MRI as follows: Ca (23, 1%), undiagnose (5, 1%), CBD stone (20, 5%), hydate_cyst (15, 4%), stricture (10%), chole (25, 6). While U\S as follows: CBD stone (34, 3%),), UN diagnose (28, 6%), hydate_cyst (14, 3%), chole_cyst (22, 9%). The etiological factors of OJ at Prox.CBD using MRI as follows: hydate_cyst (20%), chole_cyst (20%), stricture (20%), Ca (40%). While U\S as follows: stone (66, 7%), choleangio Ca (33, 3%). The etiological factors of OJ at Port. H. D. using MRI as follows: stone (50%), Ca (16, 7%), hydate_cyst (16, 7%), chole_cyst (16, 7%). While U\S as follows: stone (33, 3%), hydate_cyst (16, 7%), chole_cyst (16, 7%), UN diagnose (33, 3).