Comparison of ultrasonography and magnetic resonance cholangiopancreatography in the evaluation of obstructive jaundice: A cross-sectional observational diagnostic accuracy study.

Sanjai Sunil MBBS; G. V. Parvatheswara Rao MBBS; Veeranki Indira MBBS

doi:10.51168/saag8837

Authors

Dr. Sanjai Sunil MBBS Consultant Radiologist, Palakkad Scans, Palakkad District Co-operative Hospital and Research Centre, Palakkad, Kerala, India
Dr. G. V. Parvatheswara Rao MBBS Professor, Department of Radio-Diagnosis, Alluri Sitarama Raju Academy of Medical Sciences, Eluru, Andhra Pradesh, India
Dr.Veeranki Indira MBBS Associate Professor, Department of Biochemistry, Government Siddhartha Medical College, Vijayawada, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/saag8837

Keywords:

obstructive jaundice, ultrasonography, magnetic resonance cholangiopancreatography, biliary obstruction, diagnostic accuracy, common bile duct

Abstract

Background

Obstructive jaundice requires accurate identification of the level, extent, and cause of biliary obstruction to guide treatment. Ultrasonography (USG) is widely used as an initial investigation, whereas magnetic resonance cholangiopancreatography (MRCP) provides non-invasive multiplanar evaluation of the biliary and pancreatic ducts.

Objectives

To compare USG with MRCP in patients with obstructive jaundice, evaluate the cause, level, and extent of obstruction, identify anatomical variants, and assess diagnostic performance against intra-operative findings.

Methods

This cross-sectional observational diagnostic accuracy study included 50 patients with clinically and biochemically suspected obstructive jaundice referred to the Department of Radiology, Siddhartha Medical College, Vijayawada, from December 2022 to May 2024. Participants underwent USG and MRCP. Intra-operative findings served as the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were assessed.

Results

The mean age was 49.14 ± 16.51 years, and 56.0% were women. Pain abdomen was the commonest presenting complaint (36.0%). The mean serum bilirubin was 3.80 ± 1.72 mg/dL. Intra-operative findings showed benign lesions in 76.0% and malignant lesions in 24.0%; common bile duct calculus was the most frequent diagnosis (28.0%). USG demonstrated sensitivity of 71.23%, specificity of 95.0%, positive predictive value of 93.86%, negative predictive value of 86.0%, and diagnostic accuracy of 83.0%. Corresponding MRCP values were 92.0%, 97.0%, 92.3%, 97.2%, and 96.0%.

Conclusion

MRCP showed superior overall diagnostic performance, particularly sensitivity, negative predictive value, and accuracy, while USG retained high specificity and practical value as an initial assessment.

Recommendations

USG should remain the first-line screening examination, followed by MRCP when detailed characterization, distal duct assessment, anatomical mapping, or clarification of inconclusive findings is required.

Author Biographies

Dr. Sanjai Sunil MBBS, Consultant Radiologist, Palakkad Scans, Palakkad District Co-operative Hospital and Research Centre, Palakkad, Kerala, India

is a Consultant Radiologist at Palakkad Scans, Palakkad District Co-operative Hospital and Research Centre, Palakkad, Kerala, India. His professional interests include diagnostic radiology, ultrasonography, abdominal imaging, and hepatobiliary imaging. He is involved in the radiological evaluation and clinical interpretation of imaging findings in patients with a broad spectrum of medical and surgical conditions.
Dr. G. V. Parvatheswara Rao MBBS, Professor, Department of Radio-Diagnosis, Alluri Sitarama Raju Academy of Medical Sciences, Eluru, Andhra Pradesh, India

is Professor in the Department of Radio-Diagnosis at Alluri Sitarama Raju Academy of Medical Sciences, Eluru, Andhra Pradesh, India. He has academic and clinical experience in diagnostic radiology and is involved in undergraduate and postgraduate medical education, radiological diagnosis, academic supervision, and research. His areas of interest include abdominal imaging and advanced diagnostic imaging techniques.
Dr.Veeranki Indira MBBS, Associate Professor, Department of Biochemistry, Government Siddhartha Medical College, Vijayawada, Andhra Pradesh, India

is Associate Professor in the Department of Biochemistry at Government Siddhartha Medical College, Vijayawada, Andhra Pradesh, India. She is actively involved in undergraduate medical teaching, laboratory medicine, academic research, and scientific writing. Her academic interests include clinical biochemistry, biochemical markers of disease, interdisciplinary medical research, and the interpretation of laboratory parameters in clinical studies.

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