Diagnostic accuracy of different radiological modalities for evaluation of choledochal cyst- experience at a tertiary care center

Background: Choledochal Cysts are congenital anomalies which present as either isolated or combined dilatations of the extra and intra-hepatic biliary tree. The condition typically presents in infancy and childhood. The different radiological investigations used to diagnose choledochal cyst have different diagnostic accuracies. Methods: It is a prospective study carried out in the Department of Surgical Gastroenterology, and Department of Radiodiagnosis and Imaging Sheri-Kashmir Institute of Medical Sciences, Srinagar from October 2011 to October 2014. A total of 40 patients were taken for the study. Clinical profile, different radiological imaging details and intra operative findings were collected for each patient and the radiological reports were compared with intra operative findings. Results: Out of 40 patients 10(25%) were children upto 18 years of age and 30(75%) were adults with a male female ratio of 1:3. 29(73%) patients had type 1, 11(27%) patients had type 4 choledochalcyst. All type 1 choledocal cysts were type 1A. Hepatobiliary calculi was the most common associated feature found in around 18(45%) patients. The diagnostic accuracy for USG, CECT,MRCP,ERCP was 87%,74%,97%,93% with a sensitivity of 88%,75%,97%,91% respectively. Conclusion: Of all the investigations used in the diagnosis of choledochal cyst MRCP is the diagnostic tool of choice.