Role of magnetic resonance cholangiopancreatography in diagnosing pancreatobiliary pathologies: a prospective study

Abstract

INTRODUCTIONAccurate methods of detecting common bile duct and pancreatic disease in patients are important to both surgeons and endoscopists for planning an effective interventional strategy and therefore a need for less invasive, safe and highly sensitive diagnostic procedure. 1Various invasive and non-invasive diagnostic techniques have been employed to achieve this aim.2 Non-invasive techniques such as ultrasound and CT scan (abdomen and pelvis) are widely used in preliminary investigations of pancreaticobiliary disease, though easily available and ABSTRACT Background: Non-invasive techniques such as ultrasound and CT scan (abdomen and pelvis) are widely used in investigations of pancreaticobiliary disease, though easily available and cheap, have limitations in term of sensitivity. Invasive procedures like ERCP, though considered gold standard for diagnosis of pancreaticobiliary disease, requires highly skilled team of supporting doctors. MR Cholangio Pancreatography (MRCP) is evolving as an effective noninvasive imaging technique for examining patients with pancreatic or biliary diseases. The purpose is to illustrate the findings of MRCP in various abnormalities affecting the pancreaticobiliary diseases. Objective was to study the role of MRCP as non-invasive imaging modality for diagnosis of pancreatobiliary diseases, in diagnosing lower biliary tract pathologies, pancreatic duct pathologies, determining treatment modality in pancreatobiliary diseases, surgical or endoscopic Methods: This is a prospective study conducted in Dr. D. Y. Patil Medical College and Hospital, Pimpri, Pune for a period of two years from July 2015 to September 2017. 60 patients were enrolled in the study, their MRCP was performed following ultrasonography. Results: The MRCP diagnosed the following pathologies-cholelithiasis, choledocholithiasis, CBD stricture, chronic pancreatitis, choledochal cyst, cholangiocarcinoma, pseudocyst of pancreas, sclerosing cholangitis and GB perforation. Out of 60, 32 underwent surgical procedure and 20 underwent endoscopic procedure and 8 were treated medically. Conclusions: MRCP is very accurate in diagnosing CBD and pancreatic duct pathologies. Its helps in deciding the treatment modality for the same. It decides whether the patient requires ERCP and thus cuts down the rate of 'negative' ERCP.

Pancreatico-biliary pathologies: correlation of USG and MRCP

“…It guides the surgeon doing ERCP and thus cuts down the rate of "negative" ERCP. 11 MRCP has shown similar findings to that of ERCP in patients with suspected biliary obstruction. In patients in whom an endoscopic procedure is not possible (previous biliary enteric anastomosis, previous partial gastrectomy etc.…”

Role of Magnetic Resonance Cholangiopancreatography in Patients with Pancreatico-Biliary Diseases

“…The findings are consistent with studies conducted by Christopher D Becker et al (1998) 21 , Vishali MD et al (2004) 22 and Nirhale et al (2018). (23) Limitation: Small sample size is the important limitation in our study as most of the patiens undergo ERCP directly after USG bypassing MRCP.…”

The Value of MRCP in the Evaluation of the Level and Degree of Biliary Obstruction in Obstructive Jaundice

“…MRCP is considered as a superior modality owing to its multi-planar imaging capability and unique soft tissue resolution. [3] The MRCP technologies are able to produce high-resolution images in a very short time. Since it does not require contrast agent, sedation or radiation, it has been the most popular imaging modality for evaluating various causes of obstructive jaundice in the hepato-biliary system.…”