Abstract:
Objective: To investigate the diagnostic efficacy of
Ultrasound (Us) and Magnetic Resonance
Cholangiopancreato-graphy (MRCP) in the evaluation of
obstructive jaundice.
Patients and method: A total of 40 patients diagnosed as
obstructive jaundice were studied prospectively between Dec. 2002
and April 2004-in 4 hospital in the UAE. Clinical examination,
lab. tests and imaging techniques including U/s, MRCP, ERCP
were done to delineate the obstructive jaundice; reference technique
(Gold Standard) were ERCP and surgery
Results: Ultrasound depicted the cause of obstruction in 23
patients out of 40patients (overall sensitivity of 57%)-divided in 3
categories (stones 20 out of 32 (62.5%)-masses 2 out of 5 (40%)
and strictures 1 patients out of 3 (33%).
MRCP visualized and correctly diagnosed the cause of
obstruction in 36 patients out of 40 patients-sensitivity of (90%)-30
stones (93%)-4 masses (80%)-2 strictures (66%)
ERCP done for 33 patients and diagnosed correctly the 33
patients with sensitivity of 100%.
Surgery done for 7 patients
(iii)
U/s and MRCP were found to be the complementary
modalities of choice to delineate obstructive jaundice. U/s is carried
out as an initial screening technique to diagnose any dilatation in
the biliary ducts and with less sensitivity to delineate the cause of
obstruction. MRCP is considered as a precise technique in
diagnosing the cause and level of obstruction without using contrast
or invasive procedure.
