Magnetic resonance cholangiopancreatography in differentiating benign and malignant biliary obstruction

Background: Biliary obstruction is caused by either inflammatory or malignant stricture. The imaging evaluation of patients with biliary stricture has traditionally included US, CT and direct cholangiography. MRCP has gained wide acceptance from clinicians as an accurate and noninvasive alternative tool for evaluating pancreaticobiliary ductal abnormalities, and succeeded to replace diagnostic ERCP and make it obsolete.Aim of the work: The evaluation the role of Magnetic Resonance Cholangiopancreatography in differentiating benign and malignant biliary obstruction.Patients and Methods: This study included 25 patients with clinical picture suggestive of biliary obstruction. They were 13 males and 12 females, their aged ranged from 12 to 80 years. The patients were referred to Diagnostic Radiology and Medical Imaging Department, at Tanta University Hospital during a period from June 2021 to October 2022. Some patient's study obtained from liver institute and private centers. All patients underwent MRCP on 1.5 Tesla MRI scanner. Results: The overall accuracy of MRCP in detection of biliary dilatation and level of obstruction was 100%. However, the cause of obstruction was correctly diagnosed in 23 out of 25 patients with 92% overall accuracy. Diagnostic accuracy of conventional MRI, 2D&3D MRCP images and combined conventional T2MRI & MRCP were 84%, 80% & 92% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRCP were 90%, 93.33%, 90%, 93.33% and 92% respectivelyConclusion: MRCP is a superior modality, exhibiting higher sensitivity, specificity and diagnostic accuracy for evaluating both malignant and benign conditions in patients with biliary obstruction.