HALF-FOURIER RARE MR CHOLANGIOPANCREATOGRAPHY - EXPERIENCE IN 300 SUBJECTS

PURPOSE: To determine prospectively the clinical applications and diag nostic accuracy of half-fourier rapid-acquisition with relaxation enha ncement (RARE) magnetic resonance (MR) cholangiopancreatography (MRCP) in a large patient population. MATERIALS AND METHODS: Breath-hold, he avily T2-weighted half-Fourier RARE MRCP was performed in 265 patients with suspected pancreaticobiliary disease and in 35 control patients without symptoms or signs referrable to the biliary tract or pancreati c duct. MRCP findings were correlated: with those at direct cholangiog raphy, pathologic examination, :cross-sectional imaging, and clinical follow-up. RESULTS: Diagnostic MRCP examinations were obtained in 299 (99.7%) subjects. MRCP yielded an accuracy of 100% in determining the presence of pancreaticobiliary disease, the presence and level of bili ary obstruction, and obstruction due to bile duct calculi. The accurac y of MRCP and MR imaging in determining the presence and level of mali gnant obstruction: was 98.2%. MRCP obviated endoscopic retrograde chol angiopancreatography (ERCP) by excluding choledocholithiasis in patien ts with acute pancreatitis (n = 13) and nonspecific abdominal pain (n = 82). In patients with sclerosing cholangitis and acquired :immunodef iciency,syndrome cholangiopathy, MRCP depicted the biliary tract as cl early as did ERCP (n = 9). After failed ERCP, MRCP delineated the panc reaticobiliary tract and helped determine therapeutic options (n = 27) . CONCLUSION: Half-Fourier RARE MRCP enables accurate evaluation of pa ncreatico-biliary disease and obviates ERCP in some patients.