Diagnosis of diseases of biliary and pancreatic ducts with magnetic resonance cholangio pancreatography (MRCP)

Magnetic Resonance Cholangio Pancreatography (MRCP) is a new noninvasive imaging technique for the evaluation of bilio-pancreatic disorders. Different sequences, using both breth-hold and nonbreath-hold techniques, have been employed in order to obtain MRCP images. The authors discuss the technical aspects, particularly focusing their attention on a nonbreath-hold, threee-dimensional, fat-suppressed Turbo Spin Echo sequence, optimised on a 0.5T magnet with 15 mT/m gradients. Clinical applications of MRCP are evaluated, presenting data from both the literature and the personal experience. The main indication for MRCP study is represented by the evaluation of common bile duct obstruction, with the aim of assessing the presence of the obstruction (accuracy: 91-100%) and, subsequently, the level (accuracy: 85-100%) and the cause. The utility of associating conventional Magnetic Resonance (MR) images to MRCP in malignant strictures, in order to characterize and stage the malignant lesion is also discussed. Finally, data are presented regarding the indictions and the utility of MR-pancreatography in the evaluation of patients with chronic pancreatitis