Comparison of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in hepatobiliary disorders

ABSTRACT

Purpose of this study is to evaluate the diagnostic value of MRCP in hepatobiliary disorders and compare it with ERCP. Descriptive validation study. Radiology Department Military Hospital, Rawalpindi from 15 August 2006- 15 Feburary 2007. Fifty one consecutive patients included 37 males and 14 females were included. Out of 51 patients, 12 had malignant stricture, 05 had benign stricture, 06 had mass at porta hepatis, 05 had cholelithesis, 8 had choledocholithiasis, 03 had both cholelithesis and choledocholithesis, 3 had chronic pancreatitis, 04 had mass head of pancreas, 1 had sclerosing cholangitis and 4 patients had normal studies. MRCP was sensitive and specific. Positive and negative predictive values for choledocholithiasis were 100%, 95.3%, 100% and 97.9%. For cholelithesis and benign stricture 80%, 100%, 100% and 97.9% respectively. ERCP showed 5 cases of cholelitiasis, in comparison to MRCP, which had missed one case. In detecting malignant strictures MRCP was 91.7% sensitive and 100% specific. In cases of periampullary growths, it was difficult to cannulate the endoscope during ERCP. In these cases MRCP showed the level of obstruction non-invasively. MRCP was better in cases for chronic pancreatitis, in defining anatomy of pancreatic duct than ERCP, which has magnification factor of 1.5. Our findings confirm that MRCP, a noninvasive imaging technique of greater value in the diagnosis of hepatobiliary disorders as compared to ERCP