Comparison of diagnostic usefulness of magnetic resonance cholangiopancreatography (MRCP) with endoscopic retrograde cholangiopancreatography (ERCP) in evaluation of patients with obstructive jaundice.

Abstract

Objective: To determine the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography in diagnosis of obstructive jaundice taking Endoscopic Retrograde Cholangiopancreatography as gold standard. Study Design: Cross-sectional study. Setting: Department of Radiology, Aziz Fatima Medical and Dental Hospital, Faisalabad. Period: 1^st October 2022 to 31^st March 2023. Material & Methods: A total number of 108 patients reported at the OPD with the obstructive jaundice confirmed with liver function tests and having indication for conducting ERCP was included in this study. MRCP was done by radiologist with a torso phased-array coil. Sequence of MRCP was planned with use of 3 plane gradient-echo localizing images. By using Single–shot fast spine echo axial slices were taken. ERCP was carried out by gastroenterologist under local or general anesthesia. Assessment was done on the basis of pathology and results were compared between the two techniques where results of ERCP were taken as reference. The primary outcomes were sensitivity, specificity and negative & positive predictive values for obstructive jaundice. Results: In this study age range was 18 to 50 years with mean age of 40.805±5.98 years and mean duration of complain was 7.259±1.72months. Female gender was dominant in this study (50.9%) followed by male (49.1%). MRCP diagnosed 58(53.7%) patients while ERCP diagnosed 55(50.9%) patients with obstructive jaundice. MRCP has shown sensitivity of 85.46%, specificity 79.24% and diagnostic accuracy by 82%, PPV 81% and NPV 84% in diagnosis of obstructive jaundice (p < 0.000). Conclusion: The non-invasive technique of MRCP provides a good and reliable diagnostic option in patients with obstructive jaundice which is comparable with invasive technique of ERCP.