AMEI's Current Trends in Diagnosis & Treatment

Register      Login

VOLUME 3 , ISSUE 2 ( July-December, 2019 ) > List of Articles


Comparative Analysis of Hepatobiliary and Pancreatic Pathologies on Sonography and Magnetic Resonance Cholangiopancreatography

Arvinder Singh, Niveditha Basappa, Jatinderpal Singh

Keywords : Magnetic resonance cholangiopancreatography, Pancreaticobiliary pathologies, Sonography

Citation Information : Singh A, Basappa N, Singh J. Comparative Analysis of Hepatobiliary and Pancreatic Pathologies on Sonography and Magnetic Resonance Cholangiopancreatography. Curr Trends Diagn Treat 2019; 3 (2):45-55.

DOI: 10.5005/jp-journals-10055-0073

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Background: The pancreaticobiliary pathologies are one of the most common routinely encountered disorders. The evaluation of a suspected pancreaticobiliary pathology is a common radiological problem and is routinely diagnosed by a variety of imaging modalities including ultrasonography (USG), computed radiography, and magnetic resonance cholangiopancreatography (MRCP). Objectives: To study and compare the radiological features in pancreatic and biliary system pathology using USG and MRCP, and to compare the findings with histopathology results wherever available. Materials and methods: The prospective study was carried out on 50 patients with suspected pancreaticobiliary pathologies who underwent both USG and MRCP. Results: In our study of 50 cases, there were 34 (68%) female cases and 16 (32%) male cases with hepatobiliary pathologies. The female to male ratio was 2.1:1. The maximum number of 15 (30%) cases were between the age range of 41 years and 50 years. The dilatation of the biliary system was seen in 40 (80%) cases, cholelithiasis in 22 (44%), isolated choledocholithiasis in 16 (32%), cholecystitis in 3 (6%), pancreatic divisum in 3 (6%), choledochal cyst in 3 (6%), acute pancreatitis in 2 (4%) chronic pancreatitis in 4 (8%), and common bile duct (CBD) stricture in 2 (4%) cases; these are the most common pancreaticobiliary pathologies identified on MRCP. Ultrasonography was equally good in comparison to MRCP in identifying intrahepatic biliary radical dilatation, gallbladder distension, and cholelithiasis in 100% cases. However, the sensitivity and specificity of USG in detecting choledocholithiasis was low. Conclusion: Though USG provides a good information about the presence of biliary obstruction, it does not suggest the possible cause in many cases. Hence, USG is regarded as an initial guide to select the patients for MRI examination. Magnetic resonance cholangiopancreatography is a highly sensitive noninvasive modality in the detection of the level and cause of the biliary obstruction.

  1. Goyani B, Ukani B, Patel M, et al. Ultrasonography and magnetic resonance cholangiopancreatography correlation in patients with obstructive jaundice. Int J Med Sci Pub Health 2015;4(7):1010–1014. DOI: 10.5455/ijmsph.2015.26032015205.
  2. Barish MA, Yucel EK, Ferrucci JT. Magnetic resonance cholangiopancreatography. New England J Med 1999;341(4):258–264. DOI: 10.1056/NEJM199907223410407.
  3. Griffin N, Charles-Edwards G, Grant LA. Magnetic resonance cholangiopancreatography: the ABC of MRCP. Insights Imaging 2012;3(1):11–21. DOI: 10.1007/s13244-011-0129-9.
  4. Sugita R, Sugimura E, Itoh M, et al. Pseudolesion of the bile duct caused by flow effect: a diagnostic pitfall of MR cholangiopancreatography. AJR Am J Roentgenol 2003;180(2):467–471. DOI: 10.2214/ajr.180.2.1800467.
  5. Håkansson K, Ekberg O, Håkansson HO, et al. MR and ultrasound in screening of patients with suspected biliary tract disease. Acta Radiologica 2002;43(1):80–86.
  6. Ferrari FS, Fantozzi F, Tasciotti L, et al. US, MRCP, CCT and ERCP: a comparative study in 131 patients with suspected biliary obstruction. Med Sci Mon 2005;11(3):MT8–MT18.
  7. Upadhyaya V, Upadhyaya DN, Ansari MA, et al. Comparative assessment of imaging modalities in biliary obstruction. Indian J Radiol Imag 2006;16(4):577. DOI: 10.4103/0971-3026.32273.
  8. Kushwah A, Jain S, Agarwal R, et al. Biliary tract obstructive diseases: a comparative evaluation by ultrasonography and magnetic resonance cholangiopancreatography. Int J Scient Stu 2015;3(4):149–153.
  9. Kaur A, Malaviya A, Deepika, et al. Comprehensive evaluation of MRCP versus ultrasonography in biliary obstruction. Int. J Med Res Rev 2018;6(3):143–152.
  10. Attri A, Galhotra RD, Ahluwalia A, et al. Obstructive jaundice: its etiological spectrum and radiological evaluation by magnetic resonance cholangiopancreatography. Med J DY Patil Univ 2016;9(4): 443–450. DOI: 10.4103/0975-2870.186049.
  11. Shadan A, Malik GM, Kamili MM, et al. Role of MRCP in the evaluation of suspected biliary and pancreatic disease. JK-Practitioner 2011; 16(1-2):20–25.
  12. Bhatt C, Shah PS, Prajapati HJ, et al. Comparison of diagnostic accuracy between USG and MRCP in biliary and pancreatic pathology. Indian J Radiol Imag 2005;15(2):177–181. DOI: 10.4103/0971-3026.28796.
  13. Sarawagi R, Sundar S, Gupta SK, et al. Anatomical variations of cystic ducts in magnetic resonance cholangiopancreatography and clinical implications. Radiol Res Pract 2016;1(11):1–6. DOI: 10.1155/2016/3021484.
  14. Taourel P, Bret PM, Reinhold C, et al. Anatomic variants of the biliary tree: diagnosis with MR cholangiopancreatography. Radiology 1996;199(2):521–527. DOI: 10.1148/radiology.199.2.8668805.
  15. Reinbold C, Bret PM, Guibaud L, et al. MR cholangiopancreatography: potential clinical applications. Radiographics 1996;16(2):309–320. DOI: 10.1148/radiographics.16.2.8966289.
  16. Soto JA, Alvarez O, Lopera JE, et al. Biliary obstruction: findings at MR cholangiography and cross-sectional MR imaging. Radiographics 2000;20(2):353–366. DOI: 10.1148/radiographics.20.2.g00mc06353.
  17. Cetiner-Alpay Z, Kulali F, Semiz-Oysu A, et al. The role of magnetic resonance cholangiopancreatography and diffusion-weighted imaging for the differential diagnosis of obstructive biliary disorders. S Afr J Rad 2017;21(1):a1193. DOI: 10.4102/sajr.v21i1. 1193.
  18. Tamura R, Ishibashi T, Takahashi S. Chronic pancreatitis: MRCP versus ERCP for quantitative caliber measurement and qualitative evaluation. Radiology 2006;238(3):920–928. DOI: 10.1148/radiol. 2382041527.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.