The evaluation of anatomy and variations of biliary system by using magnetic resonance cholangiopancreatography

The aim of our study is to investigate the frequency of anatomical variations of the biliary system by using Magnetic Resonance Cholangiopancreatography (MRCP) and to investigate the diagnostic value of MRCPOur study was carried out by using the data acquired from the evaluation 165 cases? radiological images of MRCP done by any reason. However, 21 cases which did not have the optimal evaluation chance due to respiratory artefacts and abdominal fluid.were not included in the study. All of the evaluations were done with a 1.5 Tesla MR unit (Gyroscan Intera, Philips, Netherlands). Before the study, Survey images were acquired. On the coronal pilot, the area from a few cm above portohepatis to ampulla of Vater was scanned on BFFE. Afterwards, as choledoc considered the center, on the SSh MRCP scans each passed through this center, coronal and coronal oblique cross sections were takenThirty-five cases (24.3%) of 144 which were included in the study determined to have anatomical variations. 32 cases (91%) of 35 which had anatomical variations had only one variation while the remaining 3 cases (9%) had two separate variations. In our study, right posterior hepatic ductus opening to left hepatic ductus variation was recorded on 9 cases (6.2%). Aberrant right hepatic ductus opening to the common hepatic ductus was observed in 4 cases (2.8%). Trifucation variation was determined on 11 cases (7.6%) while on 4 cases (2.8%) long systic ductus (distal juction) and on 1 case (0.7%) medial junction of systic ductus, on 3 cases (2.1%) distal and medial junctions were determined. On 2 cases (1.4%) transvers settling of gall bladder and finally on 1 case (0.7%) pancreas divisum variation was determinedIn conclusion, up to a 25% frequency of the anatomical variations on the biliary system is observed. Some of these variations may lead to pathological sitiuations and may cause endoscopic and percutanous attempts to complicated conditions. Also, preoperative evaluations of transplant candidates should include the diagnosis of biliary tract variations. We suggested that the variations should be imaged with MRCP noninvazively, without using contrast agents, without ionizan radiation exposure and easily in a short period of time.Key Words: Magnetic resonance cholangiopancreatography, Variation, Biliary anatomy