Vol 61, No 1 (2002)
Case report
Published online: 2001-11-19
Bilio-pancreatic obscured with MRCP
Folia Morphol 2002;61(1):47-52.
Abstract
In this article the authors discuss whether or not diagnostic potential of
MR cholangiopancreatography is strong enough to replace direct cholangiography
in all cases. The pre-surgery analysis of a variety of pancreato-biliary disorders
diagnosed using MRCP images is presented with the emphasising the importance of
source images. Six cases of pancreato-biliary disorders are presented in which
MRCP indicated the place of ductal stenosis as well as the morphologic variants
or ductal uninspected shape which is critical for surgery or planned drainage.
Coronal and axial MRCP source and MIP images were obtained with 0,5T Gyroscan
NT. Anomalies of the biliary or pancreatic ducts included two cases of choledochal
cystic dilatation; two cases of aberrant biliary ducts, one case of gallbladder
duct variant.and a case of an additional pancreatic duct. In 3 out of 6 cases,
the MRCP source images produced using the complementary method supplied more complete
information concerning ductal junctions than the MIP images. Whereas in 3 out
of 6 cases, both kinds of images were equally reliable. In 4 out of 6 cases, endoscopy
was performed, and in 2 cases ERCP images were not diagnostic for ductal anatomy.
However, full delineation of biliary and pancreatic ducts was complete in all
MRCP images. MRCP within source images and maximum intensity projections show
particular promise for the assessment of pancreatobiliary anomalies in order to
reduce the number of higher-risk endoscopic interventions. The technique should
be the method of choice in cases of suspected pancreato-biliary anomaly resulting
from any imaging modality and is helpful for planning the optimal drainage method.
In the long run this practice would reduce the number of ducts damaged during
surgery.
Keywords: magnetic resonance (MR)bile ductspancreatic ductsvariants