MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY - A NOVEL-APPROACH TO THEEVALUATION OF SUSPECTED PANCREATICOBILIARY NEOPLASMS

Background: Magnetic resonance cholangiopancreatography (MRCP) is a ne w noninvasive diagnostic method for pancreaticobiliary (PB) imaging wi thout endoscopy, sedation, or iodinated contrast. The purpose of this study was to evaluate the ability of MRCP to depict pancreatic and bil iary ductal anatomy compared to that of endoscopic retrograde cholangi opancreatography (ERCP) and to evaluate tile ability of MRCP to accura tely diagnose PB neoplasms. Methods: Twenty patients had MRCP, and 17 also had ERCP. All studies were read prospectively by experienced revi ewers blinded to other imaging data. Pathologic diagnosis was made in all patients. Results: Bile duct dilatation seen by ERCP in 14 of 17 p atients was correctly identified by MRCP in all 14 patients, and norma l ducts were correctly identified by MRCP in the other 3 patients. The pancreatic duet was visible on MRCP in the pancreatic head in 17 of 2 0 patients, tile body in 17 of 20 patients, and the tail in 15 of 20 p atients. At ERCP, pancreatic duct dilatation was present in 11 cases a nd was identified by MRCP in 10 of them. Eighteen of 20 patients had m alignant PB neoplasms. MRCP indicated PB neoplasm in 19 patients. Seve nteen of these 19 patients had histologically confirmed malignant neop lasms pathologically whereas 2 had benign pathology (both chronic panc reatitis). Among the 17 patients who also had ERCP, MRCP and ERCP corr ectly agreed on a final diagnosis of malignant neoplasm in 14 cases. I n the three cases in which MRCP and ERCP disagreed on a final diagnosi s, MRCP was correct in one and incorrect in two. Conclusions: MRCP can accurately and noninvasively delineate PB ductal anatomy and diagnose PB neoplasms comparably to ERCP. MRCP is an interesting new noninvasi ve method for evaluating patients with suspected PB neoplasms.