Year: 2026 | Month: April | Volume: 16 | Issue: 4 | Pages: 78-85
DOI: https://doi.org/10.52403/ijhsr.20260410
Diagnostic Performance of Ultrasonography and MRCP in Differentiating Benign and Malignant Hepatobiliary Lesions
Akashdeep Kaur1, Arvinder Singh2, Kunwarpal Singh3
1Resident, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India.
2Professor & Head, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India.
3Professor, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar, Punjab, India.
Corresponding Author: Dr Akashdeep Kaur
ABSTRACT
Background: Hepatobiliary disorders frequently present with obstructive jaundice and pose a diagnostic challenge due to overlapping clinical features between benign and malignant etiologies. Accurate differentiation is essential for appropriate therapeutic decision-making and prognostication. Ultrasonography (USG) is commonly employed as the initial imaging modality because of its accessibility, cost-effectiveness, and ability to detect biliary dilatation and gallbladder pathology. However, its diagnostic performance may be limited in evaluating distal bile ducts and periampullary regions. Magnetic Resonance Cholangiopancreatography (MRCP), a non-invasive imaging technique, provides detailed visualization of the biliary tree and pancreatic ducts, thereby improving lesion characterization.
Materials and Methods: This cross-sectional observational study included 52 patients presenting with clinical suspicion of biliary obstruction. All patients underwent transabdominal ultrasonography followed by MRCP. Findings from both imaging techniques were evaluated against the definitive diagnosis, which was established using histopathological results, endoscopic assessment, or follow-up clinical outcomes. Measures of diagnostic efficacy—including sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy—were then determined and interpreted.
Results: Ultrasonography demonstrated a sensitivity of 85.7%, specificity of 25.0%, and overall diagnostic accuracy of 47.3% in differentiating benign from malignant lesions. In comparison, MRCP showed higher sensitivity (90.0%), improved specificity (60.0%), and greater overall accuracy (72.0%). MRCP was particularly superior in identifying the level and cause of biliary obstruction, as well as in delineating malignant strictures and masses.
Conclusion: While USG remains an effective first-line first-line imaging approach for evaluation of hepatobiliary disorders, MRCP provides superior diagnostic accuracy and better lesion characterization. MRCP should be considered especially in cases where malignancy is suspected or when USG findings are inconclusive.
Key words: Ultrasonography, MRCP, hepatobiliary lesions, obstructive jaundice, biliary obstruction.