Umesh Chandra Parashari1, Sachin Khanduri1, Samarjit Bhadury1, Deepika Upadhyay2, Kaushal Kishore3
1Department of Radio Diagnosis, Era’s Lucknow Medical College, Lucknow, Uttar Pradesh, India.
2Department of Radio Diagnosis, Sardar Patel Institute of Medical and Dental Sciences, Lucknow, Uttar Pradesh, India.
3Department of Radio Diagnosis, King George’s Medical University, Lucknow, Uttar Pradesh, India.
Aims and Objective: We assessed the utility of magnetic resonance cholangiopancreatography (MRCP) as a noninvasive diagnostic tool in patients with obstructive biliopathies. Materials and Methods: A prospective study was conducted on 54 patients with clinically suspected biliary obstruction. MRCP in these patients was compared and correlated with final diagnosis and their clinical profile. Statistical Analysis: Sample profile was described in terms of sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy. Pearson’s Chi-square statistics was used to assess the strength of association between diagnostic accuracy of MRCP and final diagnosis. Results: Out of the 54 patients, 50 had biliary obstruction. The cause of biliary obstruction was finally identified on the basis of direct cholangiography/surgery/histopathology. In 52 of the 54 patients, MRCP agreed with final diagnosis in identifying the level of block. MRCP agreed with final diagnosis in identifying the cause of obstruction in 48 of the 54 patients (89%). Sensitivity of MRCP in identifying the level of obstruction in comparison with final diagnosis was 100%, while diagnostic accuracy of MRCP in identifying the level of obstruction in comparison with final diagnosis was 96.29%. The correlation between MRCP and final diagnosis in diagnosing cause of obstruction was 0.95 (Pearson’s correlation coefficient, P = 0.017). Conclusion: MRCP is a safe ionizing radiation and iodinated contrast free modality which has the ability to display the biliary tree by combining the advantages of projectional and cross-sectional imaging.
Keywords: Magnetic resonance cholangiopancreatography, obstructive biliopathy, malignant stricture, benign stricture, choledocholithiasis.