Purpose. А comparative assessment of the diagnostic capability of spiral computed tomography supplemented by direct cholangiography (hCT-CG), and magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of causes of biliary obstruction (BO) of malignant and benign nature in patients with obstructive jaundice syndrome (OJ).

Materials and methods. Results of a study of patients who were treated in a surgical hospital for OJ syndrome (n = 61), in order to compare the diagnostic effectiveness of these methods in diagnosing the level and causes of BO.

Results. In diagnosing the level of BO, hCT-CG and MRCP were comparable high accuracy (100% and 100%, respectively, p = 1.00). The sensitivity, specificity and accuracy of hCT-CG in identifying the causes of BO of malignant genesis are 93.8%, 92.9% and 93.3%, respectively, benign - 92.9%, 93.8% and 93.3%. The sensitivity, specificity and accuracy of MRCP in the detection of malignant causes of BO are 66.7%, 95.4% and 87.1%, respectively, benign - 95.4%, 66.7% and 87.1%. hCT-CG compared with MRCP was more sensitive in diagnosing the causes of BO of malignant genesis and higher specificity in diagnosing the causes of BO in benign genesis (by 27.1%, p = 0.82).

Discussion. The higher sensitivity of hCT-CG as compared with MRCP in the diagnosis of the causes of BD may be due to the possibility of a more detailed visualization of extra-ductal changes. This is due to the advantages of improved spatial resolution of hCT due to the use of fine collimation, which allows to obtain a larger amount of primary data for creating multi-planar reconstructions.

Conclusion. The hCT-CG allows us to identify not only the level of BO, but also to establish its cause. hCT-CG has a high diagnostic potential comparable to MRCP in determining the level and cause of BO. Based on the higher sensitivity of hCT-CG in comparison with MRCP in the diagnosis of the causes of biliary obstruction in patients with obstructive jaundice of malignant origin, it can be recommended for inclusion in the algorithm of radiation research in this category of patients, especially if there are contraindications to MRCP.