Diagnostic Accuracy of MRCP in Obstructive Jaundice Patients Taking ERCP/Histopathological Findings as Gold Standard

Abstract Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging modality that has high diagnostic accuracy for a wide range of bile duct and pancreatic duct pathologies. Endoscopic retrograde cholangiopancreatography (ERCP) is still the gold standard for the exploration of the biliopancreatic region. This study aimed to evaluate the efficacy of MRCP as a diagnostic tool compared to ERCP in diagnosing obstructive jaundice due to various biliary pathology. A prospective study of 50 consecutive patients with biliary obstruction referred for MRCP with subsequent assessment by ERCP as a gold standard. MRCP had sensitivity, specificity of 86.7% and 85.00% in bile duct stones,94.74% and 93.55% in bile duct strictures, 100%and 100% in biliary dilatation, 100% and 100% in bile duct tumor, 100% and 100% in pancreatic dilatation, 100% and 100% in pancreatic divisum,80% and 100% in ampullary tumors and sensitivity 100% and specificity 97.37% in periampullary lesion respectively. The study concluded that MRCP has high diagnostic accuracy and is equivalent to ERCP in diagnosing bile duct tumors, biliary dilation, pancreatic duct dilation, pancreatic divisum. In case of choledocholithiasis, bile duct strictures, periampullary and ampullary mass MRCP diagnostic accuracy slightly low/comparable to ERCP. However, no significant deference in diagnostic accuracy of MRCP&ERCP in obstructive jaundice patients in this small sample size study group