The Accuracy of Transabdominal Ultrasound (TAUS) in Detection of Choledocholithiasis Keeping Magnetic Resonance Cholangiopancreatography (MRCP) as Gold Standard

Abstract

Objective: To assess the diagnostic accuracy of trans-abdominal ultrasound (TAUS) in detecting choledocholithiasis, keeping MRCP as the gold standard.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Department of Magnetic Resonance Imaging, Armed Forces Institute of Radiology & Imaging, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2018 to May 2019.
 Methodology: 102 patients of either gender, age 20-85 years with the clinical suspicion of choledocholithiasis and obstructive jaundice were included. Trans-abdominal ultrasonography was performed for radiological detection of disease. All selected cases then underwent MRCP for confirmation of findings.
 Results: Mean age of the patients was 54.27 ± 15.14 years. 47 patients (46.1%) were males, and 55 (53.9%) were females. All patients were subjected to trans-abdominal ultrasound and MRCP. TAUS showed choledocholithiasis in 82 (80.3%) patients. MRCP confirmed choledocholithiasis in 81 (79.4%) cases, whereas 21 (20.5%) revealed no choledocholithiasis. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of TAUS were 96%, 80.9%, 95%, 85% & 87.86%, respectively.
 Conclusion: Diagnostic accuracy of trans-abdominal ultrasonography in detecting choledocholithiasis is significantly high enough to be used as a first-line imaging modality as MRCP is available only in specialised care centres.

Accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) in Comparison with Endoscopic Retrograde Cholangiopancreatography (ERCP) for Diagnostic Choledocholithiasis

“…The researchers concluded that TAUS can also use for the diagnosis of choledocholithiasis as the alternative of MRCP at first line diagnosis before confirmation with ERCP. 15 In another local study, the researchers assessed EUS keeping the gold standard of ERCP for the of common bile duct stones. They included 123 patients having mean age of 50.3±13.91 years.…”

Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

“…The individuals with CBD dilatation must therefore be assessed further in order to rule out any sinister underlying causes. With diagnostic outcomes MRCP is an excellent non-invasive method for the diagnosis of various illnesses causing CBD dilatation and is comparable to ERCP in this regard (14) . Therefore, the treating physician must decide whether to pursue further research with an ERCP or stop all investigations in the event that the MRCP only shows a mildly dilated CBD.…”