[Single shot fast spin echo sequence MRI cholangiopancreatography]

To assess the value of single shot fast spin echo MR sequence (SS-FSE) in the morphological analysis of the biliary tree and pancreatic ducts and to compare its accuracy with other imaging methods.

95 consecutive patients referred for clinical and/or biological suspicion of biliary obstruction were explored with MR cholangiopancreatography (MRCP). All patients were explored with a Signa 1.5 T GE MR unit, with High Gradient Field Strength and Torso Phased Array Coil. Biliary ducts were explored with SS-FSE sequence, coronal and oblique coronal 20 mm thick slices on a 256 x 256 matrix. Total acquisition time was 1 second. Native pictures were reviewed by two radiologists blinded to clinical information. In case of disagreement, a third radiologist's judgement was requested. In 88 cases, MRCP results were compared with direct biligraphy methods.

In all cases, MRCP produced high quality images without MIP or other post-processing methods. For detection of biliary tree distensions, the concordance value of MRCP was over 91% (Kappa 0.82). For detection of biliary tree and/or pancreatic duct obstruction, MR sensitivity was 100% and specificity 91%. The overall diagnostic concordance value of MRCP was > or = 93%. Difficulties in MRCP were caused by functional diseases or benign stenosis. MRCP accurately diagnosed all lithiasic obstructions starting from a stone size of 3 mm.

MRCP produces fastly high-quality images. As it is totally safe, it can be proposed as a first intention method in biliopancreatic duct explorations.