Abdulwahid, H., Al-Mosawe, A., Jabbar, J., Nayyef, Q. (2022). The Diagnostic Accuracy of MRCP and Transabdominal Ultrasound in Patients with Obstructive Jaundice in Correlation with ERCP. , 21(1), 55-62. doi: 10.52573/ipmj.2021.174071
Hiba Mohammed Abdulwahid; Ammar Mosa Al-Mosawe; Jinan Abdul Kareem Jabbar; Qusay Tayseer Nayyef. "The Diagnostic Accuracy of MRCP and Transabdominal Ultrasound in Patients with Obstructive Jaundice in Correlation with ERCP". , 21, 1, 2022, 55-62. doi: 10.52573/ipmj.2021.174071
Abdulwahid, H., Al-Mosawe, A., Jabbar, J., Nayyef, Q. (2022). 'The Diagnostic Accuracy of MRCP and Transabdominal Ultrasound in Patients with Obstructive Jaundice in Correlation with ERCP', , 21(1), pp. 55-62. doi: 10.52573/ipmj.2021.174071
Abdulwahid, H., Al-Mosawe, A., Jabbar, J., Nayyef, Q. The Diagnostic Accuracy of MRCP and Transabdominal Ultrasound in Patients with Obstructive Jaundice in Correlation with ERCP. , 2022; 21(1): 55-62. doi: 10.52573/ipmj.2021.174071

The Diagnostic Accuracy of MRCP and Transabdominal Ultrasound in Patients with Obstructive Jaundice in Correlation with ERCP

Iraqi Postgraduate Medical Journal
Article 8, Volume 21, Issue 1, 2022, Pages 55-62    PDF (344.76 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2021.174071
Authors
Hiba Mohammed Abdulwahid1; Ammar Mosa Al-Mosawe2; Jinan Abdul Kareem Jabbar3; Qusay Tayseer Nayyef4
1Radiology Specialist, Lecturer at the College of Medicine/University of Baghdad, Baghdad, Iraq
2Radiology Specialist, Assisstant prof at the College of Medicine/Al-Nahrain University, Baghdad, Iraq
3Radiology Specialist, Oncology Teaching Hospital/Medical City /Baghdad, Iraq
4Medical Technician. Oncology Teaching Hospital/Medical City /Baghdad, Iraq
Abstract
BACKGROUND:
The validation of the non-invasive radiological tools to replace invasive procedures like Endoscopic retrograde cholangiopancreatography (ERCP)for diagnosis of biliary obstructive disease become essential in modern medical practice. Magnetic resonance cholangiopancreatography (MRCP) is best alternative for ERCP regarding diagnostic aspects.
AIM OF STUDY:
To assess the diagnostic accuracy of MRCP and transabdominal US in identifying the cause of biliary dilatation in correlation with Endoscopic retrograde cholangiopancreatography as the gold standard.
METHODS:
A prospective cross sectional analytic study that involved 64 patients with obstructive jaundice. Abdominal US and MRCP were performed and the cause of obstruction were recorded and correlated with a subsequent ERCP results which were considered as the gold standard. Accuracy, sensitivity, specificity, positive and negative predictive values and P value were calculated for each test.
RESULTS:
Choledocholithiasis was the commonest cause of biliary obstruction (45%). The detection rate for MRCP was 96.6% and for ultrasound was 41.4% regarding CBD stones. The diagnostic performance of MRCP for malignant pathologies was (‎91.7%‎) sensitivity,100% specificity, 91.7% accuracy with significant level for detection (P value <0.001).While trans-abdominal ultrasound had lower diagnostic parameters for malignancy detection with 75% sensitivity, 66.7% specifity, 41.6% accuracy and P value (0.228).
CONCLUSION:
MRCP is a non-invasive technique that can detect level and cause of biliary obstruction with high diagnostic performance especially in choledocolithiasis and malignancies. MRCP can replace the invasive ERCP as a diagnostic tool in most cases. Also if no cause was identified in MRCP, ERCP can be avoided in most cases
 
 
Keywords
MRCP; ultrasound; Obstructive jaundice; biliary dilatation; ERCP
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