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Magnetic resonance cholangiopancreatography: evaluation in 150 patients
Rajendra Prasad Tripathi1, Arun Batra, Sameer Kaushik
1NMR Research Center, Institute of Nuclear Medicine and Allied Sciences, Timarpur, Delhi.
Background And Aims:
Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging technique for evaluating the biliary and pancreatic ducts. MRCP has reached a level of resolution and reliability where it may replace diagnostic endoscopic retrograde cholangio-pancreatography (ERCP). We analyzed the results of MRCP in adult patients with biliary or pancreatic disease, and compared the findings with those at surgery or on ERCP.
Methods:
Data of 150 patients who underwent MRCP with both single slab and multislice rapid acquisition with relaxation enhancement sequences with half-fourier acquisition single-shot turbo spin echo techniques were analyzed. Patients were divided into four groups according to reason for referral for MRCP: obstructive jaundice (n = 65), chronic/acute pancreatitis (n = 25), screening prior to laparoscopic cholecystectomy (n = 20), and failed ERCP (n = 40).
Results:
MRCP could accurately identify the level of biliary obstruction in 58 of 61 patients. Characterization of benign or malignant nature of a stricture was possible in 30 of 32 patients when findings of both MRCP and magnetic resonance imaging were analyzed together. MRCP revealed the morphology of the entire pancreatic duct in 13 of 15 patients having ductal changes on endoscopic retrograde pancreatography.
Conclusion:
MRCP has high sensitivity and specificity for detection of biliary dilatation, calculi, strictures and anatomical variants.