Accuracy of magnetic resonance cholangiopancreaticography in the diagnosis of benign and malignant cause of obstructive jaundice

Accuracy of MRCP in obstructive jaundice

Authors

Keywords:

Magnetic resonance cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangiopancreatography (ERCP), Histopathological examination (HPE), Obstructive Jaundice

Abstract

Introduction: Magnetic Resonance Cholangiopancreatography (MRCP) is non-invasive technique for overall assessment for obstructive jaundice. This study aims to compare accuracy of MRCP in benign and malignant obstructive jaundice with gold standard but the invasive procedure of Endoscopic Retrograde Cholangiopancreatography (ERCP) and histopathology.

Method: This was a retrospective study reviewing MRCP findings of clinically diagnosed obstructive jaundice from 2018 to 2021 at Patan Hospital, Kathmandu, Nepal. Study was conducted after ethical clearance of the institutional review committee. Sensitivity, Specificity, PPV and NPV and overall accuracy of MRCP was compared with the ERCP and histopathology. Chi square test was used for analysis, a p<0.05 considered significant.

Result: Among 66 patients, the Sensitivity, Specificity, PPV and NPV of MRCP for biliary obstruction due to malignant pathology were 89.50%, 93.60%, 85.00% and 95.70% respectively. Similarly, for benign etiology, it was 93.60%, 89.50%, 95.70% and 85.00% respectively. The overall diagnostic accuracy was 92.40%. Choledocholithiasis were 31(46.97%) among benign cause and periampullary carcinoma 8(12.12%) among malignant.

Conclusion: MRCP is highly sensitive and specific test in the evaluation of benign and malignant biliary pathology. Being noninvasive and can have good diagnostic value despite use of contrast. So minimally invasive procedure ERCP can be reserved for therapeutic or diagnostic biopsy purpose only.

Author Biographies

Ngawang Temba Sherpa, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Lecturer,  Department of Radiology and Imaging, Patan Hospital

Sagun Manandhar, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Resident, Department of Radiology and Imaging, Patan Hospital

Anil Karki, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Lecturer, Department of Radiology and Imaging, Patan Hospital

Prabhat Karki, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Lecturer, Department of Radiology and Imaging, Patan Hospital

 

 

https://doi.org/10.3126/jpahs.v9i1.43896

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Published

2022-03-28