Multidetector Computed Tomography (MDCT) Evaluation of Obstructive Jaundice: A Cross-sectional Study from a Tertiary Hospital of Nepal

Abstract

AbstractObjectives:This study was done to evaluate the diagnostic accuracy of MDCT in assessment of obstructive jaundice in reference to surgical or histopathological diagnosis cum to study the MDCT features of various causes of obstructive jaundice.Materials and Methods:We did a cross-sectional study using purposive sampling size of 30 participants with obstructive jaundice at ... We calculated the diagnostic statistics of non-neoplastic and neoplastic type of obstructive jaundice as well as individual etiology of obstructive jaundice detected on MDCT in reference to histopathological/cytopathological and/or surgical diagnosis. The ethical clearance was obtained from the institutional review committee of … (Ref no: Acd/291/075/076-IRC).Results:The sensitivity and the NPV of MDCT for non-neoplastic cause to detect obstructive jaundice were 100% (95% CI 79.41-100.00) and 100% (95% CI 75.29-100.00), while the specificity and the PPV for neoplastic cause to detect obstructive jaundice were 100% (95% CI: 79.41-100.00) and 100% (95% CI: 75.29-100.00). Similarly, the accuracy for either non-neoplastic or neoplastic cause was 96.67% (95% CI: 82.78-99.92). The most common cause for obstructive jaundice was choledocholithiasis (33.34%) followed by cholangiocarcinoma (20%), ampullary carcinoma (13.33%) and choledochal cyst (13.33%). The diagnostic accuracy of individual etiology of common causes of obstructive jaundice ranged from 82.78 to 100%. Biliary obstruction was most frequently observed in the periampullary region (83.33%), followed by the proximal CBD (6.67%), hilar region (6.67%) and intrahepatic region (3.33%).Conclusion:The MDCT could serve as the initial, cost-effective, easily available, and time-efficient imaging modality for diagnosing various causes of obstructive jaundice, with an accuracy ranging from 82.78% to 99.92%. It can differentiate non-neoplastic from neoplastic causes of obstructive jaundice.