Ultrasound and magnetic resonance cholangio-pancreatography correlation in biliary disorders

Abstract

Biliary strictures can also be visualized with sufficient anatomic detail to determine the level of obstruction and in some instances, differentiate benign from malignant causes. MRCP has potentially two major advantages in neoplastic pancreatico biliary obstruction. Firstly, MRCP can directly reveal extraductal tumor whereas ERCP depicts only the duct lumen. Second, MRCP lacks the major complication rate of approximately 3% associated with ERCP such as sepsis, bleeding, bile leak and death. Overall the purpose of this study will be to prospectively assess the accuracy of MR imaging. A cross sectional study was carried out comprising of fifty unselected patients of different age groups in whom there was clinical suspicion of the biliary diseases. This was a prospective study carried out in the Department of Radio diagnosis, Bharati Vidyapeeth Medical College and Hospital, Pune. Each patient was separately studied by using Ultrasonography and MRCP and compared both studies with other modalities and some cases were followed up & compared with post operative findings. In the present study the cases of Duct calculi predominated and was seen in 16 patients (32%) followed by congenital (choledochal cysts) in 12 (24 %) and Gall bladder masses in 6 (12%). In our study, patients of biliary pathology especially stricture and mass lesions in lower part of CBD were better evaluated by MRCP. In patients with Klatskin tumor, in which hepatic ducts were more involved were better evaluated by MRCP. Strictures were better diagnosed by MRCP. ERCP, histopathological reports and post-operative findings were compared. MRCP was 98% accurate in diagnosis of diseases. False negative result in one patient was due to technical problem. In this patient MRCP diagnosis was mass lesion in 2nd part of duodenum, but per operation mass was in the head of pancreas.

Keywords

• ultrasound
• magnetic resonance
• biliary disorders