Evaluation of Obstructive Jaundice Using Magnetic Resonance

Abstract

Obstructive jaundice is one of the most frequent and grave form of hepatobiliary disease.It can pose It problems in diagnosis and management,particularlyIntrahepaticCholestasis. To evaluate the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography(MRCP) in studying the cause of obstructive jaundice, cholestasis diagnosing and differentiating benign from malignant lesions and to compare it with USG findingsalong with histopathological and surgical correlation. 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. 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 by 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%) Ultrasound is a good screening method but is less accurate for diagnosing the distal CBD obstruction .MRCP on the other hand has high sensitivity for diagnosing the cause and extend of biliary obstruction and hence should be the modality of choice for all the patient presenting with obstructive jaundice .