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23541

Role of Magnetic Resonance Cholangiopancreatography in Evaluation of Biliary Obstruction

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Last updated: 24 Dec 2024

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Abstract

Background: obstructive jaundice which is caused by bile duct obstruction can be clinically and biochemically indistinguishable from cholestatic jaundice caused by hepatocellular disease. The management of both these conditions being radically different, the principle task of the radiologist is to differentiate between hepatocellular and obstructive jaundice, by using available imaging modality and help in further management. With the availability of non-invasive modality like magnetic resonance imaging (MRI), it is possible to diagnose obstructive jaundice early and accurately without any patient discomfort. The purpose of this article is to describe the protocol for evaluation of obstructive jaundice with use of magnetic resonance cholangio pancreatography sequence of MRI and to describe the imaging features of the most common causes of obstructive jaundice like biliary calculi, bile duct strictures, choledochal cyst, gall bladder carcinoma, cholangiocarcinoma, primary sclerosing cholangitis, and pancreatic head carcinoma. Aim of work: this work aimed to study and evaluate the role of MRCP in patients with biliary obstruction. Patients and Methods: this study included 30 patients with biliary obstruction during the period from December 2017 to October 2018. MRCP was performed on a 1.5 T MRI system, using a phased-array body coil. Fasting for 4 hours prior to the examination is required to reduce gastro-duodenal secretions, reduce motility to eliminate motion artifacts and to promote distension of gall bladder.For optimum visualization of ducts, acquired images were reformatted in different planes using multiplanar reconstruction (MPR) and maximum intensity projection (MIP). Results: in all cases, MRCP displayed the different parts of the biliary tract and localized the exact site of obstruction in all of the obstructed cases. According to the morphology encountered at the site of obstruction, MRCP was found highly specific in differentiating the calcular, malignant and benign causes of obstruction.  The quality of images were degraded by the presence of massive ascites, marked patient obesity in our study by the instability to hold breath in a reproducible manner. Lack of the therapeutic role and the inability to perform functional studies mainly at the papilla remain the main limitation of the technique. Conclusion: MRCP should be the next step following depiction of biliary obstruction by U/S. Consequently in the near future there will be no place for the diagnostic use of the ERCP which shall be then restricted to a therapeutic role. 

DOI

10.21608/ejhm.2019.23541

Keywords

MRCP,  obstructive jaundice,  biliary stricture,  cholangiocarcinoma, choledocholithiasis 

Authors

First Name

Mohamed Farouk

Last Name

Aggag

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Affiliation

Department of Radiology, Faculty of Medicine, Al-Azhar University

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First Name

Mohamed Said Abdul Aziz

Last Name

Shehata

MiddleName

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Affiliation

Department of Radiology, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Ziad El Sayed El Sayed

Last Name

Badawy

MiddleName

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Affiliation

Department of Radiology, Faculty of Medicine, Al-Azhar University

Email

ziadelsayed@hotmail.com

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Volume

74

Article Issue

3

Related Issue

4351

Issue Date

2019-01-01

Receive Date

2019-01-03

Publish Date

2019-01-01

Page Start

550

Page End

557

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_23541.html

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https://ejhm.journals.ekb.eg/service?article_code=23541

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12

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Role of Magnetic Resonance Cholangiopancreatography in Evaluation of Biliary Obstruction

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Article

Created At

22 Jan 2023