The Role of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Obstructive Jaundice


ABSTRACT:BACKGROUND:Evaluation of jaundiced patients should include proper history and examination, laboratory investigation and imaging investigations (non invasive like US, CT and MRI or invasive like ERCP and PTC).AIM OF STUDY:The aim of this prospective study is to evaluate the role of US and MRI-MRCP in patients with obstructive jaundice in clinical practice.METHODS:This is a prospective study performed on 80 patients (42 female and 38 male) with an average age of 53 years presented with obstructive jaundice for whom abdominal ultrasound (US) and magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) performed in the departments of radiology in Al-Kadhemiyyah teaching hospital and Specialized surgical hospital and Baghdad teaching hospital from October 2003 to October 2005. The final diagnosis was found by endoscopic retrograde cholangiopancreatography (ERCP) and or surgery and confirmed by histopathology.RESULTS:The most common cause of obstructive jaundice in our study was tumors (41.25%) followed by common bile duct stones (36.25%) then benign strictures (13.75%), hydatid cyst (6.25%) & finally choledochal cyst (2.5%). In this study, MRI-MRCP could differentiate surgical from medical jaundice in all cases, while US could differentiate surgical from medical jaundice in 91.25% of cases. MRI-MRCP correctly defines the level of obstruction in all cases (100%).While US correctly define the level of obstruction in only 86.2 % of the total cases. MRI-MRCP correctly suggests the most possible cause of obstruction in 96.25% of cases. While US correctly suggests the most possible cause in only 36.2 %.CONCLUSION:So that US, 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 US or ERCP in studying the extent & staging of malignant lesions