Obstructive jaundice: Its etiological spectrum and radiological evaluation by magnetic resonance cholangiopancreatography

Abstract

Background: Magnetic resonance cholangiopancreatography (MRCP) has reached a level of resolution and reliability where it may replace diagnostic endoscopic retrograde cholangiopancreatography. We studied the role of MRCP in adult patients with obstructive biliopathy to analyze its etiological spectrum and radiological findings. Materials and Methods: Total fifty patients referred for mrcp with a clinical diagnosis of obstructive jaundice were included in our study. Imaging findings were correlated with the final diagnosis made by histopathological or cytological findings and with the therapeutic outcome. Aim: To evaluate the role of MRCP in the determination of the etiological spectrum, to evaluate level and degree of biliary obstruction in cases of obstructive jaundice and to correlate findings on mrcp with surgical findings where possible. Results: Of fifty patients, 29 were benign lesions and 21 were malignant lesions. Among the benign lesions, 12 had choledocholithiasis and 16 had benign strictures. One case was of a choledochal cyst. Among the malignant lesions, 12 were gallbladder carcinoma, six were cholangiocarcinoma, two were periampullary carcinoma, and one was a case of metastatic deposit. The overall sensitivity of MRCP was 96.5%, specificity was 95.2%, and with an accuracy of 96% for benign lesions. The accuracy, sensitivity, and specificity of MRCP in the diagnosis of benign strictures was 92%, 93.7%, and 91.2%, for choledocholithiasis was 92%, 75%, and 97.3%, and for malignant lesions was 95.2, 96.5%, and 96%, respectively. Conclusion: MRCP is a relatively quick, accurate, and noninvasive imaging modality for the assessment of obstructive jaundice, in ruling out potentially correctable underlying cause.

Keywords

• Benign stricture
• choledocholithiasis
• gallbladder carcinoma
• magnetic resonance cholangiopancreatography