EVALUATION OF ACCURACY OF ULTRASONOGRAPHY IN OBSTRUCTIVE JAUNDICE WITH MAGNETIC RESONANCE CHOLANGIOPANCREATOLOGRAPHY CORRELATION

Abstract

Evaluation of a suspected biliary tract disease is a common radiological problem and is traditionally diagnosed by a variety of imaging modalities including Ultrasonography (USG), Computed tomography and Invasive cholangiography and Magnetic Resonance Cholangiopancreatography (MRCP) [1]. 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 the probable cause. This was a prospective study conducted in a tertiary care hospital in South India from March 2011 to March 2012. Patients clinically suspected to have obstructive jaundice were interrogated personally and their clinical data was recorded in a proforma. Special emphasis was given to the presence of cholestatic features like pruritus and pale stools in the history. All the patients presented with jaundice. Pruritis at some stage of illness was complained by 42 out of 50 (84%). Pain abdomen and fever suggesting cholangitis were observed in about half of the patients. In all the 50 patients in this study the intrahepatic duct were dilated. The extent to which the site of obstruction can be ascertained from ultrasound examination is variable in the work done by various workers.  The figure of 92% in our study the diagnostic accuracy in assessing the site of obstruction compares well with that reported by studies done by other authors. In conclusion diagnostic accuracy of ultrasound and MRCP in a correct assessment of site of obstruction was very high and comparable to each other. But MRCP was better (90%) than ultrasound (80%) in correct predicting the cause of obstruction.

Key words: Ultrasonography, Magnetic Resonance Cholangiopancreatography (MRCP), biliary obstruction, jaundice