DIAGNOSTIC ACCURACY OF BILIARY TRACT ULTRASOUND IN DIAGNOSIS OF CAUSE OF OBSTRUCTIVE JAUNDICE KEEPING MAGNETIC RESONANCE CHOLANGIOPANCREATICOGRAPHY (MRCP) AS GOLD STANDARD

Abstract

Objectives: To assess the accuracy of ultrasound of biliary tract to determine the cause of obstructive jaundice by comparing with MRCP considered as the gold standard.

Study design: Cross-sectional (validation) study.

Place and Duration of the study: Combined Military Hospital, Rawalpindi from February 2024 to July 2024.

Methodology: A total of 294 patients with obstructive jaundice were included. They were assessed for the cause of their condition first by ultrasonography of their biliary tree followed by MRCP and whether the cause was identified or not was documented, in addition to the cause itself. Causes were stratified by confounding variables and post-stratification comparison was performed using Chi-square test. 2x2 contingency tables were drawn to calculate diagnostic accuracy parameters.

Results: In this study, 294 patients were included. Median age was 45.00 (19.00) years. There were 146 (49.70%) male and 148 (50.30%) female patients. Median weight was 78.00 (52.00) kg. Median duration of having jaundice was 4.00 (4.00) weeks. On ultrasound, obstructive jaundice cause was identified in 194 (66.00%) patients while on MRCP, cause was identified in 246 (83.70%) of the patients. Based on these findings, sensitivity was calculated to be at 77.24%, specificity at 91.67%, accuracy at 79.59%, positive predictive value at 97.94% and negative predictive value at 44.00%.

Conclusion: Ultrasound of biliary tree can identify cause of obstructive jaundice in most instances with an accuracy of 79.59%.