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, ERCPor 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 MRCPimaging 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 . Aprospective 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 MRCPwhich included sensitivity, specificity and accuracy by comparing with surgical, histopathological or ERCPfindings. Statistical analysis was done by using chi-square test and p-value was calculated.We observed high sensitivity and specificity of MRCPin differentiating benign from malignat biliary strictures. In this study, 20 cases of benign stricture were correctly diagnosed on MRCPbased 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 MRCPin 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%. PPV96.87 % and NPV90.91%