British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 8, Issue.: 11
Comparative Study to Assess Diagnostic Reliability of Ultrasound and 3T-MRCP in Patient of Obstructive Jaundice
Manoher Singh Rathore1, Vishakha Rathore2, Amit Kumar3, Gaurav Kapoor4, Neeraj Gour5* and Deepak Kumar Jain6 1Department of Radiodiagnosis, Rajiv Gandhi Cancer Hospital and Research Center, New Delhi, India.
2Department of Gynaecology, P.D Hinduja Hospital, Mumbai, India.
3Department of Radiodiagnosis, Max Superspeciality Hospital, Delhi India.
4Department of Radiodiagnosis, Rockland Superspeciality Hospital, Delhi, India.
5Department of Community Medicine, SHKM GOVT Medical College, Haryana, India.
6Department of Oncology, Tata Memorial Hospital, Mumbai, India.
Manoher Singh Rathore1, Vishakha Rathore2, Amit Kumar3, Gaurav Kapoor4, Neeraj Gour5* and Deepak Kumar Jain6
1Department of Radiodiagnosis, Rajiv Gandhi Cancer Hospital and Research Center, New Delhi, India.
(1) Rakesh Garg, Department of Anaesthesiology, Intensive Care, Pain and Palliative Care, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi, India.
(1) Marco Matteo Ciccone, Cardiology Department, University of Bari, Italy.
(2) Anonymous, Kaohsiung Medical University, Taiwan.
Complete Peer review History: http://www.sciencedomain.org/review-history/9564
Background: Evaluation of jaundice patients should include proper history and examination, laboratory investigation and imaging investigations (non invasive like Ultrasound (U\S), CT and MRI or invasive like ERCP and PTC).
Aim of Study: The aim of this prospective study is to evaluate the diagnostic reliability of U\S and MRI-MRCP in patients of obstructive jaundice in clinical practice.
Materials and Methods: This is a prospective study performed on 60 patients (31 male and 29 female) with an average age of 55.53 +/- 17.57 years presented with obstructive jaundice for whom abdominal ultrasound (U\S) and magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) on 3 Tesla was performed in the departments of radiology in Max super speciality teaching hospital, saket, Delhi, India from May 2012 to May 2013. The final diagnosis was achieved by endoscopic retrograde cholangiopancreatography (ERCP) and \or surgery and confirmed by histopathology.
Results: The most common cause of obstructive jaundice in our study was common bile duct stones (51.65%) followed by tumors (33.3%) then benign strictures (10.0%), choledochal cyst (3.33%). In this study, MRI-MRCP could differentiate surgical from medical jaundice in all cases, while U\S could differentiate surgical from medical jaundice in 91.25% of cases. MRI-MRCP correctly defines the level of obstruction in all cases (100%). While U\S correctly define the level of obstruction in only 78% of the total cases. MRI-MRCP correctly suggests the most possible cause of obstruction in 96.25% of cases. While USG is correctly suggests the most possible cause in only 76.3%.
Conclusion: So that USG as a screening modality is useful to confirm or exclude biliary dilatation & to choose patients for MRCP examination. MRI-MRCP is a useful non-invasive and essential method in the preoperative evaluation of patients with obstructive jaundice. In addition MRI-MRCP was superior to U\S or ERCP in studying the extent & staging of malignant lesions.
Ultrasound; MRI; MRC; obstructive jaundice.
Full Article - PDF Page 919-930
DOI : 10.9734/BJMMR/2015/16708Review History Comments