Comparison of computed Tomography and ultrasonography in evaluating causes of obstructive jaundice

  • Dr. Mrs. Lovely Kaushal Professor Head of the Department, Department of Radio diagnosis and Imaging, Gandhi Medical College, Bhopal, Madhya Pradesh, India
  • Dr. Abhijit Patil Associate Professor, Department of Radio diagnosis and Imaging, Gandhi Medical College, Bhopal, Madhya Pradesh, India
  • Dr. Chandra Prakash Ahirwar Assistant Professor, Department of Radio diagnosis and Imaging, Gandhi Medical College, Bhopal, Madhya Pradesh, India
  • Dr. Kshitij Sharma Post graduate student, Department of Radio diagnosis and Imaging, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Keywords: Computed Tomography, Ultrasonography, Obstructive jaundice, Biliary obstruction

Abstract

Objective: To observe and compare the role of ultrasonography and computed tomography in evaluation of causes of obstructive jaundice.

Materials and Methods: A total of 100 patients were enrolled in this cross-sectional study done in Department of Radiodiagnosis and Imaging, Gandhi Medical College, Bhopal.

Results: Computed tomography and ultrasonography were able to detect the presence of biliary obstruction in 100% of cases. Liver function tests were altered in all the patients with alkaline phosphatase raise out of proportion to the AST/ALT. The highest incidence of biliary obstruction was found in 61-70 years’ age group with mean (±SD) age of the patient was 62.7 ± 12.64 years. Sensitivity, specificity and accuracy of computed tomography and ultrasonograhy in detecting the various causes of obstructive jaundice were 90.85%, 99.21% ,98.15% and 84.15%, 98.86% and 97% respectively.

Conclusions: Computed tomography has a high sensitivity, specificity and accuracy in detecting the causes of biliary obstruction. Considering these attributes, computed tomography can be used as an effective diagnostic modality in cases of obstructive jaundice. Accuracy and specificity for ultrasonography is high in detecting the causes of biliary obstruction with a slightly low sensitivity. Hence, ultrasonography can be used as an effective screening modality in cases of obstructive jaundice.

Downloads

Download data is not yet available.

References

1. Nadkarni KM, Jahagirdar RR, Kagzi RS, Pinto AC, Bhalerao RA. Surgical obstructive jaundice. J Postgrad Med. 1981 Jan;27(1):33-9. [PubMed]

2. Baron RL, Stanley RJ, Lee JKT, Koehler RE, Melson GL, Balfe DM, Weyman PJ. A prospective comparison of the evaluation of biliary obstruction using computed tomography and ultrasonography. Radiology 1982 Oct;145(1);91-98. DOI:10.1148/radiology.145.1.7122903. [PubMed]

3. Sharma MP, Ahuja V. Aetiological spectrum of obstructive jaundice and diagnostic ability of ultrasonography: a clinician's perspective. Trop Gastroenterol. 1999 Oct-Dec;20(4):167-9. [PubMed]

4. Naffisaadedin et al, comparison of ultrasonography and computed tomography to evaluate causes of biliary obstruction; Euroasian journal of hepato-gastroenterology, 2012July-December;2(2):98-103.

5. Laing FC: The gallbladder and bile ducts. In Rumack CM , Wilson SR, Charboneau JW (Eds): Diagnostic ultrasound(2nd ed.) St. Louis, CV Mosby, 1998, pp 175-224.

6. Reinus WR, Shady K, Lind M, Scott R. Ultrasound evaluation of the common duct in symptomatic and asymptomatic patients. Am J Gastroenterol. 1992 Apr;87(4):489-92. [PubMed]

7. Baron RL, Tublin ME, Peterson MS. Imaging the spectrum of biliary tract disease. Radiol Clin North Am. 2002 Dec;40(6):1325-54. [PubMed]

8. Co CS, Shea WJ Jr, Goldberg HI. Evaluation of common bile duct diameter using high resolution computed tomography. J Comput Assist Tomogr. 1986 May-Jun;10(3):424-7. [PubMed]

9. Upadhyaya V, Upadhyaya DN, Ansari MA, Shukla VK. Comparative assessment of imaging modalities in biliary obstruction. Indian J Radiol Imaging 2006;16:577-82.

10. Siddique K, Ali Q, Mirza S, Jamil A, Ehsan A, Latif S, Malik AZ. Evaluation of the aetiological spectrum of obstructive jaundice. J Ayub Med Coll Abbottabad. 2008 Oct-Dec;20(4):62-6. [PubMed]

11. Britton J, Bickerstaff KI, Savage A. Diseases of biliary tract. In: Morris PJ, Wood WC(Eds). Oxford Textbook of Surgery, (2nd edition), Oxford University Press 2000;1685.

12. Singh A, Mann HS, Thukral CL, Singh NR. Diagnostic Accuracy of MRCP as Compared to Ultrasound/CT in Patients with Obstructive Jaundice. J Clin Diagn Res. 2014 Mar;8(3):103-7. doi: 10.7860/JCDR/2014/8149.4120. Epub 2014 Mar 15. [PubMed]

13. Rigauts H, Marchal G, Van Steenbergen W, Ponette E. Comparison of ultrasound and E.R.C.P. in the detection of the cause of obstructive biliary disease. Rofo. 1992 Mar;156(3):252-7. [PubMed]

14. Anderson SW, Lucey BC, Varghese JC, Soto JA. Accuracy of MDCT in the diagnosis of choledocholithiasis. AJR Am J Roentgenol. 2006 Jul;187(1):174-80. [PubMed]

15. Khalili K, Wilson SR.The biliary tree and Gall bladder.In: Rumack CM, Wilson SR, Charboneau JW(Eds). Diagnostic Ultrasound (3rded), Elsevier,Mosby 2005;142:725-28. [PubMed]

16. Yeh HC. Ultrasonography and computed tomography of carcinoma of the gallbladder. Radiology. 1979 Oct;133(1):167-73. [PubMed]

17. Ghafoor N. Role of ultrasound and computed tomography in the diagnosis of gall bladder malignancy.MD thesis, BIRDEM, Dhaka, Bangladesh, 2006.

18. Kumaran V, Gulati S, Paul B, Pande K, Sahni P, Chattopadhyay K. The role of dual-phase helical CT in assessing resectability of carcinoma of the gallbladder. Eur Radiol. 2002 Aug;12(8):1993-9. Epub 2002 Apr 19.

19. Yoshimitsu K, Honda H, Shinozaki K, Aibe H, Kuroiwa T, Irie H, Chijiiwa K, Asayama Y, Masuda K. Helical CT of the local spread of carcinoma of the gallbladder: evaluation according to the TNM system in patients who underwent surgical resection. AJR Am J Roentgenol. 2002 Aug;179(2):423-8.

20. Pradhan S, Shukla VK, Agrawal S, Dixit VK, Sharma OP. Sonographic and colour doppler morphology in carcinoma gallbladder. Indian J Cancer. 2002 Oct-Dec;39(4):143-8. [PubMed]

21. Hann LE, Greatrex KV, Bach AM, Fong Y, Blumgart LH. Cholangiocarcinoma at the hepatic hilus: sonographic findings. AJR Am J Roentgenol. 1997 Apr;168(4):985-9. [PubMed]

22. Thomas MJ, Pellegrini CA, Way LW. Usefulness of diagnostic tests for biliary obstruction. Am J Surg. 1982 Jul;144(1):102-8. [PubMed]

23. Hessel SJ. Siegelman SS, McNeil BJ, Sanders R, Adams DF, Alderson PO, Finberg HJ, Abrams HL. A prospective study of evaluation of computed tomography and ultrasound of the pancreas. Radiol 1982 Apr:143(1):129-33. [PubMed]

24. Weltman DI, Zeman RK. Acute diseases of the gallbladder and biliary ducts. Radiol Clin North Am. 1994 Sep;32(5):933-50. [PubMed]

25. Paulson EK. Acute cholecystitis: CT findings. Semin Ultrasound CT MR. 2000 Feb;21(1):56-63. [PubMed]

26. Bhargava SK, Usha T, Bhatt S, Bhargava S. Imaging in obstructive jaundice: A review with our experience JIMSA. 2013;26:12-4.
Comparison of computed Tomography and ultrasonography in evaluating causes of obstructive jaundice
CITATION
DOI: 10.17511/ijmrr.2016.i08.28
Published: 2016-08-31
How to Cite
1.
Kaushal L, Patil A, Prakash Ahirwar C, Sharma K. Comparison of computed Tomography and ultrasonography in evaluating causes of obstructive jaundice. Int J Med Res Rev [Internet]. 2016Aug.31 [cited 2024Apr.27];4(8):1448-55. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/663
Section
Original Article