Title: Role of MRI-MRCP in Evaluation of Obstructive Jaundice

Authors: Arjun Raju P, Divyashree, Surabhi Mehrotra

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i3.08

Background- Evaluation of a suspected biliary tract disease is a common surgical problem and traditionally diagnosed by a variety of imaging modalities including Ultrasonography (USG), Computed tomography (CT), Invasive cholangiography and Magnetic Resonance Cholangiopancreatography (MRCP). In a suspected case of biliary obstruction with clinical and laboratory findings suggestive of obstructive jaundice, the main aim of radiologist is to confirm the presence of obstruction and to identify its location, extent and probable cause.

Aim Of Study- To evaluate the diagnostic value of MRCP in studying the sites and causes of obstructive jaundice, and to determine the accuracy of MRCP in the diagnosis of obstructive jaundice.

Materials & Methods- Twenty patients with clinical & biochemical features of obstructive jaundice who presented to the department of radiodiagnosis between October 2015 and September 2016 were enrolled in this study. The final diagnosis was found by endoscopic retrograde cholangiopancreatography (ERCP) and \or surgery and confirmed by histopathology.

Results- MRCP was able to diagnose ductal dilatation and hence, differentiate surgical from medical jaundice in all the patients (100%). MRCP was accurately able to detect the level of obstruction in 100% of cases. The most common cause of obstructive jaundice was pancreatico-biliary tumors (50%), followed by choledocholithiasis (40%). MRCP was accurately able to detect the cause of obstruction in 95% of cases.

Conclusion- Magnetic resonance imaging – magnetic resonance cholangiopancreatography (MRI-MRCP) is a highly sensitive non-invasive technique in the detection of the presence of biliary obstruction in addition to defining its level and cause. The accuracy of magnetic resonance cholangiopancreatography and its non-invasiveness have considerably restricted the diagnostic role of Endoscopic retrograde cholangiopancreatography (ERCP).

Keywords- Obstructive jaundice, MRI, MRCP.

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