COMPARISON OF MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AND ULTRASOUND IN THE DIAGNOSIS OF BILE DUCT DILATATION
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Keywords
BSMMU, Bile duct dilatation, Choledocholithiasis, Diagnostic accuracy, MRCP, Ultrasound.
Abstract
Bile duct dilatation, a crucial radiological indicator of obstruction, necessitates accurate diagnostic imaging. Although Ultrasound (USG) serves as the primary screening tool, Magnetic Resonance Cholangiopancreatography (MRCP) offers superior visualization of the biliary tree, warranting a comparative evaluation of their diagnostic efficacy. Objective: To compare the diagnostic accuracy of MRCP and USG in detecting bile duct dilatation. Methods: This study was conducted at the Department of Radiology and Imaging, BSMMU, Dhaka, Bangladesh (January 2011-July 2012). Seventy-eight patients with suspected biliary obstruction were selected through purposive sampling. All underwent both USG and MRCP, with final diagnoses confirmed surgically, endoscopically, or clinically. Data analysis using SPSS 20.0 assessed sensitivity, specificity, predictive values, and accuracy. Results: MRCP demonstrated significantly higher sensitivity (95.2% vs. 77.6%) and specificity (97.8% vs. 84.5%) than USG. It excelled in detecting choledocholithiasis (92.3% vs. 68.4%), malignant strictures (94.1% vs. 72.5%), and mild dilatation (89.5% detection vs. USG’s 57.9%). False-positive rates were lower for MRCP (2.2% vs. 15.5%). Overall accuracy favored MRCP (96.2% vs. 80.8%, p < 0.001). Conclusion: MRCP outperforms USG in diagnosing bile duct dilatation, particularly for subtle or distal pathologies. While USG remains practical for screening, MRCP should be prioritized for equivocal cases. Strategic use of MRCP in resource-limited settings can optimize diagnostic accuracy and patient outcomes.
References
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Iffat Sultana
Assistant Professor, Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mohammad Saifullah
Assistant Professor, Department of Surgery, Sir Salimullah Medical College, Dhaka, Bangladesh.
Morsheda Begum
Assistant Professor, Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
Md. Towhid Hossain
Assistant Professor and Head, Department of Histopathology, National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka, Bangladesh.