Comparative Analysis of Hepatobiliary and Pancreatic Pathologies on Sonography and Magnetic Resonance Cholangiopancreatography

Abstract

Background: The pancreaticobiliary pathologies are one of the most common routinely encountered disorders. The evaluation of a suspected pancreaticobiliary pathology is a common radiological problem and is routinely diagnosed by a variety of imaging modalities including ultrasonography (USG), computed radiography, and magnetic resonance cholangiopancreatography (MRCP). Objectives: To study and compare the radiological features in pancreatic and biliary system pathology using USG and MRCP, and to compare the findings with histopathology results wherever available. Materials and methods: The prospective study was carried out on 50 patients with suspected pancreaticobiliary pathologies who underwent both USG and MRCP. Results: In our study of 50 cases, there were 34 (68%) female cases and 16 (32%) male cases with hepatobiliary pathologies. The female to male ratio was 2.1:1. The maximum number of 15 (30%) cases were between the age range of 41 years and 50 years. The dilatation of the biliary system was seen in 40 (80%) cases, cholelithiasis in 22 (44%), isolated choledocholithiasis in 16 (32%), cholecystitis in 3 (6%), pancreatic divisum in 3 (6%), choledochal cyst in 3 (6%), acute pancreatitis in 2 (4%) chronic pancreatitis in 4 (8%), and common bile duct (CBD) stricture in 2 (4%) cases; these are the most common pancreaticobiliary pathologies identified on MRCP. Ultrasonography was equally good in comparison to MRCP in identifying intrahepatic biliary radical dilatation, gallbladder distension, and cholelithiasis in 100% cases. However, the sensitivity and specificity of USG in detecting choledocholithiasis was low. Conclusion: Though USG provides a good information about the presence of biliary obstruction, it does not suggest the possible cause in many cases. Hence, USG is regarded as an initial guide to select the patients for MRI examination. Magnetic resonance cholangiopancreatography is a highly sensitive noninvasive modality in the detection of the level and cause of the biliary obstruction.