Application Of MRCP In The Clinical Diagnosis Of Obstructive Jaundice

Purpose To compare the value of magnetic resonance cholangiopan-creatography(MRCP),research the MRCP features of bile duct obstruction,evaluate its advantage and disadvantage.Methods 72 cases doubted with obstructive jaundice were examinedby conventional MRI and MRCP.The diagnosis was compared with USand CT.Discriminant analysis with chi-square test and exact probabilitiesin 2x2 table were used to the results.Results 1.The accuracy of the bile duct obstruction locationsdiagnosed by the MRCP images was 100%.The accuracy of benignobstruction was 82.9%,and which of cancerous obstruction was 78.4%.There was no signifi-cant difference between them(P>0.05);2.Theaccuracy of the obstructive jaundice diagnosed only by the MRCP imageswas 61.1%, images combined with conventional MRI was 80.6%,andthere was significant difference between them(P<0.05);3.The accuracy ofobstructive jaundice diagnosed by the MRCP images was not higherobveriously than US and CT;4.The menifestation of cancerous obstructionis mainly bile duct dilatation in mid-grade and high grade, and doubleduct sign was seen only in cancerous obstruction,especially in carcinomaof the pancreatic head and the carcinoma of the ampulla.While themenifestation of benign obstruction is mainly in low grade andmid-grade.There was significant difference between them(P<0.05).Conclusion As a result, we draw the following conclusions : (1)As anew technology recently, the accuracy of the bile duct obstructionlocations diagnosed by the MRCP images was 100%. (2)Combiningconventional MRI with MRCP is accurate and noninvasive for theassessment of malignant obstructions of biliary system from benign ones.The accuracy of the concretion in biliary system diagnosed by the MRCPimages is high in some extend. (3) The accuracy of the obstructivejaundice diagnosed by the MRCP images is not higher obveriously thanUS and CT,but the MRCP has some benefits such as beingnoninvasive,without scathe,showing all biliary system.(4)The main defectof the MRCP is its low specifity of disease in biliary system and thedifficulty of distinguishing obstructions of biliary system from benignones.