ARE WE UNDERUTILIZING CECT FOR EVALUATION OF BILIARY PATHOLOGIES?

Mariam Shah, Bilqees Yawar Faiz, Maira Aslam, Aroosa Kanwal, Sadia Riaz

Abstract


ABSTRACT

OBJECTIVE:

This study aims to compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) in detecting biliary and pancreatic duct pathologies and to emphasize the value of Contrast-Enhanced CT (CECT). While MRCP is effective for imaging these ducts, CECT provides additional clinically relevant information outside the ductal systems and is more cost-effective.

MATERIAL AND METHODS:

This retrospective cross-sectional study was conducted after obtaining IRB approval, using data from the RIS database. Patients referred to the radiology department of Shifa International System with biliary or pancreatic ductal pathologies from January 2018 to August 2021 were included. A total of 53 patients, aged 20–80 years, who underwent both CECT and MRCP simultaneously, were included in the study. Findings from the CECT were reviewed by a senior radiologist on PACS, blinded to the MRCP results.

RESULTS: The study included 53 patients with a mean age of 49 years. MRCP revealed dilatation of the right hepatic duct (75.5%), left hepatic duct (73.6%), common hepatic duct (58.5%), common bile duct (37.7%), and pancreatic duct (13.2%). Pathological findings included stones (20.8%), strictures (52.8%), periampullary and CBD mass (17%), and wall thickening (9.4%). CECT demonstrated high diagnostic accuracy (96.2%), with similar detection rates for biliary pathologies. In comparison, MRCP showed dilatation in the right hepatic duct (71.7%), left hepatic duct (69.8%), common hepatic duct (56.6%), common bile duct (35.8%), and pancreatic duct (13.2%). Stones were detected in 20.8%, strictures in 51%, wall thickening in 7.4%, and masses in 17% of cases.

 

 

 

 

 

CONCLUSION:

CECT is comparable to MRCP in detecting the majority of biliary and pancreatic duct pathologies and provides additional clinically significant information. CECT is also a cost-effective imaging modality.

 

KEY WORDS: Contrast enhanced CT (CECT), magnetic resonance cholangiopancreatography (MRCP), Obstructive jaundice.

 

 


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