Role of 3T Magnetic Resonance Cholangiopancreatography (MRCP) In Biliary Strictures in Adult Population of Western India

Dr.Suvinay Saxena; Dr. Dinesh Prajapati; Dr.Mrugesh Doctor; Dr.Hemant Patel

Volume : VIII, Issue : VII, July - 2019

Role of 3T Magnetic Resonance Cholangiopancreatography (MRCP) In Biliary Strictures in Adult Population of Western India

Dr. Suvinay Saxena, Dr. Dinesh Prajapati, Dr. Mrugesh Doctor, Dr. Hemant Patel

Abstract :

The aim of the study was to evaluate role of Magnetic Resonance Cholangiopancreatography in differentiating benign from malignant causes of biliary strictures in adults using surgical, ERCP or histo–pathological findings as gold standard.

The objectives of the study were to confirm the diagnosis of the biliary strictures , to localize the level of obstruction, to characterize the morphological features of stricture to differentiate benign from malignant cause on MRCP imaging and correlate with the surgical/ ERCP / histo–pathological findings whenever its applicable.

Study was conducted in Gujarat Imaging centre Post graduate institute of Radiology and Imaging (GIC–PGIR), Samved hospital, Ahmedabad .Patients with clinical and laboratory finding suggestive of biliary obstruction were imaged . A prospective study was performed evaluating 80 patients for a duration of 1 year with clinical and laboratory finding suggestive of biliary obstruction referred to the hospital for Magnetic resonance Cholangiopancreatography.

MRI (3– Tesla, Philips achieva with 16 array channel coil) with high resolution specific serial sections. Diagnostic effectivity was calculated for MRCP which included sensitivity, specificity and accuracy by comp� with surgical, histopathological or ERCP findings. Statistical analysis was done by using chi–square test and p–value was calculated.

We observed high sensitivity and specificity of MRCP in differentiating benign from malignat biliary strictures. In this study, 20 cases of benign stricture were correctly diagnosed on MRCP based on patient�s clinical history and MR characteristic findings. Two cases which were coined as benign strictures of distal CBD on MRCP, turned out malignant on post interventional cytology result. 31 cases of malignant stricture were correctly diagnosed on MRCP.Overall diagnostic accuracy of MRCP in differentiating benign from malignant biliary strictures in correlation with ERCP, surgical and histo–pathological outcome was 94.44 % , sensitivity 93.94% , specificity was 95.24%. PPV 96.87 % and NPV 90.91%.