Magnetic resonance chlangiopancreatography: Diagnostic value and comparision with direct cholangiographic

Magnetic Resonance Cholangiopancreatography (MRCP) is a newly described technique that does not require the use of contrast agents or biliary intervention. The aim of our study was to evaluate whether MRCP can provide useful information about the biliary tract, compared with other direct cholangiography techniques. 36 patients were examined with fat saturated heavily T2-weighted, two dimensional, flow compansated, multislab fast spin-echo sequence for MRCP. All patients were studied with a IT superconducting magnet by using body coil. MRCP sequence acquired in coronal and axial planes. Saturation bands were used all around the biliary system (TR/TE= 11000/266, M=256xl92, NEX=8). Coronal images were post-processed with the maximum-intensity-projection (MO*) algorithm. In addition an axial T 1 -weighted sequence was acquired for detailed examination of pancreatic head (TR/TE= 560/1 1, M=128x256). Diagnostic MR images were obtained in 34 (%94.4) of 36 patients. ERCP was unsuccesful or nondiagnostic in 9 of the 34 patients (%26.5). PTC was applied to 7 patients. 5 patients had both ERCP and PTC. Choledocholithiasis was correctly evaluated by MRCP in 23 of 25 patients(%92) with a %100 specifity. The presence and the level of the biliary obstruction were accurately shown in 30 of 32 patients with MRCP (%93.75). The main disadvantage of MRCP when compared to ERCP or PTC is that it does not allow any interventional therapeutic procedures. One should examine the source images and the MIP reconstructions together to avoid false negative results. In conclusion, MRCP is shown to be a very sensitive; easy to perform and noninvasive technique in the evaluation of the biliary tree and it can be used in many patients when invasive techniques are difficult or before therapeutic direct cholangiographic procedures.