Authors: C D Becker M Grossholz G Mentha R de Peyer F Terrier
Publish Date: 2014/02/12
Volume: 7, Issue: 6, Pages: 865-874
Abstract
The objective of this article is to review technical aspects discuss potential clinical indications for MR cholangiopancreatography MRCP and demonstrate the spectrum of diagnostic findings in benign postoperative and malignant conditions We describe our current imaging protocol in comparison with other available techniques Using a nonbreathhold heavily T2weighted fastspinecho FSE sequence with or without respiratory gating we obtained coronal and axial source images and maximum intensity projections MIPs in 102 patients with suspected abnormalities of the biliary or pancreatic ducts Based on this series we demonstrate the diagnostic appearance of a variety of benign postoperative and malignant conditions of the biliary and pancreatic ducts and discuss potential clinical indications for MRCP The nonbreathhold FSE technique enables a consistent image quality even in patients who cannot cooperate well Respiratory gating increased the rate of diagnostic examinations from 79 to 95 Acquisition of coronal and axial source images enables detection of bile duct stones as small as 2 mm although calculi that are impacted and not surrounded by hyperintense bile may sometimes be difficult to detect The MIP reconstructions help to determine the level of obstruction in malignant jaundice delineate anatomical variants and malformations and to diagnose inflammatory conditions e g sclerosing cholangitis the Mirizzi syndrome and inflammatory changes in the main pancreatic duct The MRCP technique also correctly demonstrates the morphology of bilioenteric or biliobiliary anastomoses Because MRCP provides sufficient diagnostic information in a wide range of benign and malignant biliary and pancreatic disorders it could obviate diagnostic endoscopic retrograde cholangiopancreatography ERCP in many clinical settings The ERCP technique may be increasingly reserved for patients in whom nonsurgical interventional procedures are anticipated
Keywords: