NONINVASIVE EVALUATION OF THE BILIARY TREE WITH MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY - INITIAL CLINICAL-EXPERIENCE

Magnetic resonance cholangiopancreatography is a new, non-invasive ima ging technique for visualization of the biliary ducts. Magnetic resona nce cholangiopancreatography was performed on 136 patients (20-87 year s old) with a superconductive magnet at 0.5T (Philips Gyroscan T5), Vo lumetric images on coronal planes were acquired; a T2 weighted turbo s pin echo sequence (TR=3000; TE=700; number of excitations=8; echo trai n length=128; Acquisition time-5'48 '') with respiratory compensation was performed, Images were reconstructed on coronal planes rotated at different angles using the MIP algorithm, When neoplastic disease was detected additional images on axial planes (SE Tlw: TR/TE 300/10 and t urbo spin echo T2w: TR/TE 3000/120) were acquired, Magnetic resonance cholangiopancreatography allowed images of diagnostic value to be obta ined in all cases, In choledocholithiasis, the technique had a sensiti vity of 91.6%, specificity of 100% and overall diagnostic accuracy of 96.8%, Of the 48 patients with stenotic lesions, 16 cases were correct ly characterized as benign and 30 as malignant, Two cases of focal chr onic pancreatitis were misdiagnosed as pancreatic head carcinoma, In p atients submitted to bilioenteric anastomosis, the technique was able to detect dilation of intrahepatic ducts, stenosis and associated ston es in the 8 positive cases, In all 11 patients with chronic pancreatit is, dilated Wirsung duct and the stenotic tracts were revealed, In con clusion, magnetic resonance cholangiopancreatography can be considered as a technique able to completely replace diagnostic endoscopic retro grade cholangiopancreatography. However, further studies are necessary for a better evaluation of potential advantages and disadvantages.