Comparative diagnostic evaluation with ultrasonography, MSCT, MRCP and ERCP in patients with obstructive jaundice

Objective To compare the diagnostic accuracy of endoscopic retrograde cholangiopancreatography (ERCP) with ultrasonography, multislice spiral computed tomography (MSCT) and magnetic resonance cholangiopancreatography (MRCP) on the location and etiology of obstructive jaundice.Methods 128 patients underwent ultrasonography, MSCT and ERCP, and 35 patients underwent MRCP.Results For the diagnosis of the location of obstructive jaundice, there is no significant difference found on evaluation of intrahepatic ducts and head of pancreas diagnosed by the four methods.Although ERCP has no significant difference with MRCP in investigating extrahepatic ducts but ERCP is superior to ultrasonography and MSCT.As for the etiology of obstructive jaundice, there is no significant difference found on evaluation for gallstone, cholangitis and carcinoma of the head of pancreas diagnosed by the four methods.MRCP, MSCT and ERCP were all better than ultrasonography for the diagnosis of cholangiocarcinoma, further more, ERCP was better than ultrasonography and MSCT for duodenal papilla cancer and juxtapapillary duodenal diverticula diagnosis. Conclusion ERCP has an important value in diagnosing the location (especially extrahepatic ducts, duodenal papilla) and etiology (especially cholangiocarcinoma and duodenal papilla cancer) of obstructive jaundice.