The Role of Ultrasound U/s and Magnetic Resonance Chngiopancreatogrphy MRCP in the Evaluation of Obstructive Jaundice

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.