Our First Experience with Magnetic Resonance Cholangiopancreaticography

Overview

Background.
Magnetic resonance cholangiopancreaticography (MRCP) is based on heavily weighted T2 sequences(ETSE – echo-train spin echo) with suppression of fat, giving visualisation of slowly flowing or stagnating fluid.MRCP are short sequences in coronary plane with thickness of 8 cm or 4 mm. Retrospective analysis of all MRCPexaminations performed during last 12 months is presented.Methods and Results. Eighty-eight examinations were done, of which 67 ones with both adequate technical qualityand clinical indication were included into the study (20 males aged 25–83ye ars, 47 women aged 19–82 years).Patients were divided into 4 groups regarding to the indications (group I. – temporary cholestasis, normal abdominalultrasound, II. – definite cholestasis, III. – pathologic findings on pancreas, IV. – other). Vast majority of patientswere included into group I (35 subjects). In 7 (20 %) of them choledocholithiasis and/or stenoses (including multiplestenoses in primary sclerotizing cholangoitis) were found. MRCP brought diagnostic information in subjects withcholestasis (group II.) and answered questions given by clinicians. However, in 1 of 4 subjects with primarysclerotizing cholangoitis,MRCP did not reveal intra-hepatic stenoses, which were later visualised by classical ERCP.Only the extrahepatic stenoses were diagnosed by MRCP in the latter subject.Conclusions. MRCP should become a standard examination in the diagnostic algorithm in patients with cholangiopathies.MRCP has its value not only in subjects with unsuccessful or contraindicated ERCP, but also in subjectswith temporary cholestasis with negative ultrasound finding.

Key words:
MRCP, stenosis, choledocholithiasis.