Imaging the Biliary Tract: Comparable Roles of Ultrasonagraphy and Magnetic Resonance

The Role of Magnetic Resonance Imaging (MRI) in the diagnosis of pancreatico-biliary pathology is well recognized, Ultrasonography (US) continues to play a pivotal role however. With escalating health costs the expense incurred in obtaining MRI requires justification. The aim of this study was to examine the comparable roles of US and MRI in a group of patients with suspected biliary tract disease over a twelve month period.

Twenty four patients were recruited. All underwent abdominal US and MRI. The indication for US included abdominal pain (87%) Jaundice (25%) and/or deranged liver function tests (71%). Indications for MRI included suspected Choledocholithiasis clinically (51%) and ultrasonographically (21%), suspicion of pancreatic pathology (16%) or inconclusive ultrasound (12%).

Ultrasound identified common bile duct (BCD) dilatation in 21%. A normal CBD was identified in 67%. Pancreatic pathology was described in 16% (carcinoma, cysts, inflammation). Inconclusive studies accounted for 12%. MRI identified CBD dilatation in 25%. A normal CBD was identified in 75%. Pancreatic pathology was confirmed in 16%.

In conclusion MRI confirmed all positive US findings. The principle benefit of MRI was in establishing findings in the 12% of inconclusive US studies we suggest that adopting a more selective practice could reduce the demand and associated cost implications of MRI.