[Magnetic resonance cholangiopancreatography]

Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging test with excellent overall sensitivity and specificity for demonstrating the level and presence of biliary obstruction. Selected MRCP sequences allow relatively stagnant fluids, such as bile and pancreatic juice, to have a high-signal intensity compared with the dark signal of adjacent solid organs and circulating blood, without the use of a contrast agent. Its inability to offer therapeutic interventions is a major weakness of MRCP. MR cholangiopancreatography demonstrates biliopancreatic system at the coronal planes similar to direct cholangiography. Due to very high negative predictive value, MRC has a potential to substitute invasive diagnostics in all patients with suspected choledocholithiasis reserving it for the patients that require therapeutic intervention. MR cholangiography may be useful in establishing the resectability of a malignant neoplasm such as hilar cholangiocarcinoma by helping determine the proximal extent of disease where ERCP may not be successful and in distal obstructions in which percutaneous cholangiography may be of limited value.