What investigation is most likely to establish the liver diagnosis in a patient with abnormal liver function tests?

The correct answer, which indicates the most likely investigation to establish a liver diagnosis in a patient presenting with abnormal liver function tests, is a magnetic resonance cholangiopancreatography (MRCP). This imaging technique is particularly beneficial because it provides detailed images of the hepatobiliary system, including the bile ducts, gallbladder, pancreas, and liver. It is especially useful for detecting conditions such as bile duct obstructions, cholangitis, and liver lesions, which can contribute to abnormal liver function test results.

In cases where liver function tests are abnormal, understanding the underlying cause is crucial for effective management. MRCP allows for a non-invasive assessment of these structures, helping to identify potential anatomical causes of liver dysfunction. Conditions such as primary biliary cholangitis, choledocholithiasis, or malignant obstruction can often be visualized with this method.

Other investigations, while useful in different contexts, do not provide the same level of detail regarding the anatomy of the bile ducts and liver. For example, antimitochondrial antibodies are primarily used to support the diagnosis of primary biliary cholangitis but do not help in visualizing the liver anatomy or identifying obstructive pathology. A CT scan of the abdomen can provide some information about liver