DOI: http://dx.doi.org/10.18203/2349-2902.isj20192969

Pancreatico-biliary pathologies: correlation of USG and MRCP

Priyanka Ashok Khopde, Abhimanyu Kelkar, Priscilla Joshi, Amol Bandgar, Mangal Mahajan

Abstract


Background: Obstructive jaundice is the most frequent form of hepato-biliary pathologies. The main aim is to confirm the presence of obstruction and to identify its cause, location and extent of the lesion. This study evaluated the role of USG and MRCP in hepato-biliary pathology.

Methods: Twenty-five patients of all age groups with suspicion of obstructive jaundice referred for Ultrasound were included in our study. The patients with findings suggestive of biliary obstruction underwent MRCP.

Results: Out of 25 patients, maximum patients were in the age group of 61-80 yrs. 52% were male and 48% were female. The jaundice was due to a benign etiology in 64% patients and malignant etiology in 36%. The most common benign pathology was choledocholithiasis (25%) and malignant pathology was periampullary carcinoma (44%). Overall 11 cases were inconclusive on ultrasound study while 2 cases were false positive for malignancy on MRCP. In 92% cases the correct diagnosis was detected on MRCP.

Conclusions: USG is the initial and sometimes the only imaging modality in obstructive biliary disease. However the distal CBD which is poorly seen on USG can be well evaluated on MRCP thus improving the diagnosis in pancreatico-biliary pathologies.


Keywords


Benign, Common bile duct, Magnetic resonance cholangiopancreatography, Malignant, Pancreatic duct, Ultrasound

Full Text:

PDF

References


Bhargava SK, Usha T, Bhatt S, Kumari R, Bhargava S. Imaging in obstructive jaundice: A review with our experience. JIMSA. 2013;26:12-4.

Siva Prasad A, Sandeep J. Ultrasound and magnetic resonance cholangio-pancreatography correlation in biliary disorders. MRIMS. 2015;3(2).

Kim JH, Kim MJ, Park SI, Chung JJ, Song SY, Yoo HS, Lee JT. Using kinematic MR cholangiopancreatography to evaluate biliary dilatation. American J Roentgenol. 2002;178(4):909-14.

Kushwah AP, Jain S, Agarwal R, Tomar SP. Biliary tract obstructive diseases: a comparative evaluation by ultrasonography and magnetic resonance cholangiopancreatography (magnetic resonance imaging). Int J Sci Study. 2015;3(4):149-53.

SuthaR M, PuRohit S, BhaRgaV V, Goyal P. Role of MRCP in differentiation of benign and malignant causes of biliary obstruction. JCDR. 2015 Nov;9(11):TC08.

Munir K, Bari V, Yaqoob J, Khan DB, Usman MU. The role of magnetic resonance cholangiopancreatography (MRCP) in obstructive jaundice. J Pak Med Assoc. 2004;54(3):128-32.

Bhatt C, Shah PS, Prajapati HJ, Modi J. Comparison of diagnostic accuracy between USG and MRCP in biliary and pancreatic pathology. Indian J Radiol Imaging. 2005;15(2):177.

Al-Obaidi S, Al-Hilli MR, Fadhel AA. The role of ultrasound and magnetic resonance imaging in the diagnosis of obstructive jaundice. Iraqi Postgrad Med J. 2007;6(1):7-17.

Diwanji N, Dibbad RB, Sastri M, Desai E. The study of role of magnetic resonance cholangio-pancreatography (MRCP) in pancreato-biliary disorders. Int J Med Sci Public Health. 2016;5(12):2635-40.

Zhong L, Yao QY, Li L, Xu JR. Imaging diagnosis of pancreato-biliary diseases: a control study. World J Gastroenterol. 2003;9(12):2824.

Nirhale DS, Kulkarni GC, Shingade P, Chavan S, Sonawane T, Dhende M. Role of magnetic resonance cholangiopancreatography in diagnosing pancreatobiliary pathologies: a prospective study. Int Surg J. 2018;5(6):2233-7.

Adamek HE, Albert J, Breer H, Weitz M, Schilling D, Riemann JF. Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective controlled study. Lancet. 2000;356(9225):190-3.