MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY IN OBSTRUCTIVE JAUNDCE

Abstract

Jaundice is a yellow pigmentation of tissues caused by the presence of excessive amounts of bile pigments, it appears clinically when the total bilirubin in plasma is above 2 mg% (Carbon et al, 1982).

Jaundice is classified as haemolytic, hepatocellular and obstructive. Obstructive jaundice is due to failure of adequate amount of bile to reach the duodenum which occurs any where between sinusoidal membrane of the hepatocytes and the ampulla of Vater this may be due to common bile duct stone, pancreatic and ampullary carcmomas, cholangiocarcinoma, benign or iatrogenic stricture (Sherlock and Dooley, 1997).

Imaging ductal anatomy and delineating stricture in patients with low bile duct obstruction can usually be achieved easily by ultrasound, (US) computed tomography and cholangiography (either endoscopic retrograde cholangiopancreatography (ECRP) or percutaneous transhepatic cholangiography (Margaret et al, 1993).

ERCP is complicated by · pancreatitis and endoscopy related problems such as perforation and aspiration pneumonitis (Zimmon et al, 1975). Complications of PTC are related to hepatic puncture including pain, haemorrhage, haemobilia and pneumothorax (Okuda et al, 1974).

The non invasive techniques like ultrasound and computed tomography are currently the modalities of choice for diagnosis of biliary ducts dilatation, however, CT is limited to axial plane, with the risk of radiation exposure and anaphylaxsis due to contrast media. Also, US has a limited field of view and is operator dependent (Brend et al, 1991).