ROLE OF MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH SURGICAL JAUNDICE

Dr Hashim P I; Dr Vikas Chauhan

Volume : VIII, Issue : IX, September - 2019

ROLE OF MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH SURGICAL JAUNDICE

Dr Hashim P I, Dr Vikas Chauhan

Abstract :

Aim: To evaluate the effectiveness of Magnetic Resonance Imaging and Magnetic Resonance Cholangio Pancreatography in imaging various pathological conditions causing surgical jaundice and assessing the level of obstruction. Methods: Hundred consecutive patients who were admitted to the Surgical Gastroenterology ward at a tertiary care centre with clinical and biochemical evidence of obstructive jaundice were evaluated using MRI& MRCP.Liver function tests, routine blood, urine examinations ultrasonography and in case necessary CT scan were done. The patients were then subjected to a detailed MRI& MRCP examination and then followed up with endoscopy in some selected cases. Based on the MRI findings, lesions were classified initially into benign or malignant variety. The malignant lesions were further characterized and categorized.After surgery, the post operative findings and findings at a histopathological examination were compared to the MRI&MRCP findings. Results: In our study MRI&MRCP as a modality in the diagnosis of obstructive jaundice had a sensitivity of 98% and a specificity of 100%, with a diagnostic accuracy of 94%.MRI& MRCP was accurate in 96–97% of cases in detecting the level and cause of obstruction. Benign lesions were the most common cause of obstructive jaundice in this group at 60%. Of the benign lesions, the highest incidence was CBD calculus (28%) followed by benign CBD stricture (10%).For post operative stricture MRI had a sensitivity of 80% and a diagnostic accuracy of 100%. Conclusions: MRCP in conjuction with MRI is a safe, non–invasive and accurate investigation in the evaluation of obstructive jaundice. It is non–ionising, non operator dependent and more accurate in depicting the level and cause of obstruction than other modalities like USG, ERCP, PTC or CT and hence should be the investigation of choice in case of surgical jaundice