DIAGNOSTIC ACCURACY OF ULTRASOUND SONOGRAPHY TEST AND COMPUTED TOMOGRAPHY COMPARED WITH MAGNETIC RESONANCE CHOLANGIO PANCREATOGRAPHY IN PATIENTS WITH OBSTRUCTIVE JAUNDICE CONSIDERING ENDOSCOPIC RETROGRADE CHOLANGIO PANCREATOGRAPHY AS GOLD STANDARD
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Abstract
Objective: To determine the diagnostic accuracy of USG and CT compared with MRCP in the patients with obstructive jaundice considering ERCP as the gold standard
Methodology: This cross-sectional study at Mayo Hospital, Lahore, spanned 6 months and included 71 cases meeting predefined criteria. A senior radiologist prepared all reports. The study used preliminary ultrasound, CECT abdomen, and MRCP for patients with cholestatic jaundice, comparing results with ERCP. MRCP showed higher diagnostic accuracy.
Results: MRCP proved to be the most accurate in diagnostic accuracy. Its sensitivity and specificity for benign conditions were 94.87% and 93.75% while for CT it was 87.18% and 81.25% and for USG it was 84.62% and 90.63% respectively. For malignant conditions sensitivity and specificity for MRCP was 93.75% and 97.44% for CT it was 87.5% and 92.31% and for USG it was 81.25% and 89.74% respectively.
Conclusion: The results of this study demonstrate that MRCP is a superior modality, exhibiting higher sensitivity, specificity, and diagnostic accuracy for evaluating both malignant and benign conditions in patients with obstructive jaundice compared to USG and contrast-enhanced CT. MRCP's specificity for various etiologies matches that of ERCP, which is considered the gold standard. While MRCP's cost and availability may be a concern, its non-invasiveness, contrast-free nature, and high diagnostic accuracy make it an ideal choice for evaluating patients with obstructive jaundice.
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References
REFERENCES
Le Huong NT, An NTT. Jaundice in adult in-patients at a tertiary general hospital. Journal of Biosciences and Medicines. 2015;3(02):1.
Hanif H, Khan SA, Muneer S, Adil SO. Diagnostic accuracy of ultrasound in evaluation of obstructive jaundice with MRCP as gold standard. Pakistan Journal of Medical Sciences. 2020;36(4):652.
Chhettri P, Rana H. Ultrasonography and Magnetic Resonance Cholangiopancreatography in Patients with Obstructive Jaundice. Journal of College of Medical Sciences-Nepal. 2020;16(1):6-11.
Makmun D, Fauzi A, Shatri H. Sensitivity and specificity of magnetic resonance cholangiopancreatography versus endoscopic ultrasonography against endoscopic retrograde cholangiopancreatography in diagnosing choledocholithiasis: the Indonesian experience. Clinical endoscopy. 2017;50(5):486-90.
Khopde PA, Kelkar A, Joshi P, Bandgar A, Mahajan M. Pancreatico-biliary pathologies: correlation of USG and MRCP. International Surgery Journal. 2019;6(7):2373-8.
Farrukh SZ-u-I, Siddiqui AR, Haqqi SA, Muhammad AJ, Dheddi AS, Niaz SK. Comparison of ultrasound evaluation of patients of obstructive jaundice with endoscopic retrograde cholangio-pancreatography findings. Journal of Ayub Medical College Abbottabad. 2016;28(4):650-2.
Singh A, Mann HS, Thukral CL, Singh NR. Diagnostic accuracy of MRCP as compared to ultrasound/CT in patients with obstructive jaundice. Journal of clinical and diagnostic research: JCDR. 2014;8(3):103.
Attri A, Galhotra RD, Ahluwalia A, Saggar K. Obstructive jaundice: Its etiological spectrum and radiological evaluation by magnetic resonance cholangiopancreatography. Medical Journal of Dr DY Patil University. 2016;9(4):443.
Dillman JR, Patel RM, Lin TK, Towbin AJ, Trout AT. Diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) versus endoscopic retrograde cholangiopancreatography (ERCP) in the pediatric population: a clinical effectiveness study. Abdominal Radiology. 2019;44:2377-83.
Murtaza Gondal SMC, Ahmad I, Hussain T, Awan S, Gondal KFM, Ch SM, et al. Accuracy of MRCP in Comparison with ERCP for Diagnosing Hepato-Pancreatico-Biliary Pathologies. Journal of Rawalpindi Medical College. 2018;22(2).
Baiu I VB. Endoscopic Retrograde Cholangiopancreatography. JAMA. 2012;320(19):2050.
Patel VB, Musa RK, Patel N, Patel SD. Role of MRCP to determine the etiological spectrum, level and degree of biliary obstruction in obstructive jaundice. Journal of Family Medicine and Primary Care. 2022;11(7):3436-41.
Goud S, Devi BV, Kale PKG, Lakshmi A, Reddy VVR. To study diagnostic efficacy of ultrasound and magnetic resonance cholangiopancreatography in obstructive jaundice. Journal of Dr NTR University of Health Sciences. 2020;9(4):217.
Naz N, Aymen U. Diagnostic Accuracy of Magnetic Resonance Cholangio-Pancreatography in Choledocholithiasis. Journal of the Dow University of Health Sciences (JDUHS). 2016;10(3):77-81.
Irom P, Shetty P, Aggarwal A. Diagnostic utility of MRCP in obstructive jaundice and comparison with CT & ultrasonography. International Journal of Radiology and Diagnostic Imaging. 2022;5(3):1-6.
Salam F, Islam NF, Parveen F, Afrin T, Nazmul Hakim H, Saha TK. Comparison among the role of different imaging techniques in diagnosis of malignant lesions causing obstructive jaundice. Journal of Bangladesh College of Physicians and Surgeons. 2021;39(4):233-40.
Zhang Z-Y, Wang D, Ni J-M, Yu X-R, Zhang L, Wu W-J, et al. Comparison of three-dimensional negative-contrast CT cholangiopancreatography with three-dimensional MR cholangiopancreatography for the diagnosis of obstructive biliary diseases. European journal of radiology. 2012;81(5):830-7.
Lee DH, Kim B, Lee ES, Kim HJ, Min JH, Lee JM, et al. Radiologic evaluation and structured reporting form for extrahepatic bile duct cancer: 2019 consensus recommendations from the Korean Society of Abdominal Radiology. Korean Journal of Radiology. 2021;22(1):41.
Shrestha M. The Radiological Study to Determine the MRCP's Accuracy over USG and CT in Diagnosing Obstructive Jaundice. European Journal of Molecular & Clinical Medicine. 2022;9(1):1846.
Parsuram Jena D, Misra AP, Jena D. To establish the accuracy of MRCP over USG & CT in diagnosing the case of obstructive Jaundice with radiological study.
Petrescu I, Bratu AM, Petrescu S, Popa BV, Cristian D, Burcos T. CT vs. MRCP in choledocholithiasis jaundice. J Med Life. 2015;8(2):226-31.
Debbarma B, Reang C, Tripura K. Diagnostic efficacy of ultrasonography against magnetic resonance cholangiopancreatography in obstructive biliopathy. European Journal of Molecular & Clinical Medicine. 2022;9(16):1232.
Abdulwahid HM, Al-Mosawe AM, Jabbar JAK, Nayyef QT. The Diagnostic Accuracy of MRCP and Transabdominal Ultrasound in Patients with Obstructive Jaundice in Correlation with ERCP. Iraqi Postgraduate Medical Journal. 2022;21(1).
Nurman ANA. Imaging of common bile duct stones. Universa Medicina. 2009;28(1):59-68.
Klimkowski SP, Fung A, Menias CO, Elsayes KM. Gallbladder Imaging Interpretation Pearls and Pitfalls: Ultrasound, Computed Tomography, and Magnetic Resonance Imaging. Radiologic Clinics. 2022;60(5):809-24.
Hindman NM, Arif-Tiwari H, Kamel IR, Al-Refaie WB, Bartel TB, Cash BD, et al. ACR Appropriateness Criteria® Jaundice. Journal of the American College of Radiology. 2019;16(5):S126-S40.