Role of Multi-Phasic Contrast Enhanced Computed Tomography Scan In The Evaluation of Malignant Obstructive Jaundice
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
Introduction-Multi phasic Multi detector computed tomography (MDCT) is an ideal method for evaluation of malignant obstructive jaundice due to its superb ability to visualise the biliary and vascular architecture of liver and pancreaticobilliary system . Aim of the study is to find out the role of MDCT scan in the evaluation of malignant obstructive jaundice with respect to nature, cause and level of the obstruction. Methods- This was a prospective study conducted over period of 18 months. MDCT evaluation of 44 cases with suspected malignant obstructive jaundice with respect to nature ,cause and level of obstruction was performed. Results- Mean age of patients 66±10.75 years. MDCT findings on the basis of level of obstruction(p=0.018) , with respect to nature of obstruction (p=0.001), to radiological TNM staging(p=0.018) showed significant association. There was 100% correlation between the MDCT diagnosis and the final diagnosis regarding the level and nature of obstruction. MDCT was able to determine the cause of obstruction with a sensitivity of 100 % and accuracy of 91.9% with only four cases being wrongly diagnosed. Most of the cases were in advanced stage of disease progression and their resectability was accurately assessed by MDCT scan with high sensitivity (94.12%) and specificity (88.89%) while correlating with final outcome i.e operative or palliative management. Most nonresectable tumours (Gall bladder and Cholangio carcinoma) involving the proximal intrahepatic or perihilar biliary channels were managed with Percutaneous stenting by interventional radiologists while most of the nonresectable distal pancreaticobilary tumours were managed with ERCP guided stenting by gastroenterology department. Conclusion- MDCT with good reformatting techniques has excellent accuracy in the evaluation of malignant obstructive jaundice.
Authors and Affiliations
Nishant Yadav, Nihar Ranjan Mohanty, Madhusmita Mohanty
Keywords
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- EP ID EP395396
- DOI 10.9790/0853-1709071826.
- Views 65
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