PANCREATIC DISEASES - EVALUATION WITH MR CHOLANGIOPANCREATOGRAPHY

Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive di agnostic modality capable of producing high-quality images of the bili ary tree and pancreatic duct. We evaluated the MRCP capability of depi cting the normal pancreatic duct and, based on data achieved, studied the usefulness in the pathologic pancreatic duct. MRCP was performed i n 42 patients without any pancreatic lesion and in 162 patients with p ancreatic diseases, including congenital anomalies of biliary tree and pancreatic duct. Results were compared with endoscopic retrograde cho langiopancreatography (ERCP) in 93 patients. The visualization of the pancreatic duct and its branches and the presence or absence of dilata tion, stenosis, and filling defects were recorded. All images were int erpreted retrospectively and blindly by three radiologists. Among cont rol patients, the main pancreatic duct (MPD) was depicted in the head, body, and tail of the pancreas in 41 (98%), 39 (93%), and 31 (74%), a nd accessory pancreatic duct and secondary branches in the head, body, and tail of the pancreas were depicted in 11 (26%), eight (19%), four (10%), and two (5%) of these patients. Compared with ERCP, MRCP overe stimated the stenosis of MPD and underestimated the dilatation of the branches and filling defects in the pancreatic duct in pancreatic dise ases, especially pancreatitis. However, MRCP was distinctly advantageo us over ERCP in diagnosing mucin-producing tumor of the pancreas, cyst ic lesions, and depicting the whole, including the part distal to the obstructed site. Four of the eight cases of pancreas divisum, and 10 o f the 12 cases of anomalous pancreaticobiliary duct union also were de monstrated. MRCP can accurately demonstrate the normal pancreatic duct as well as various pancreatic duct abnormalities, including congenita l anomalies of the biliary tree and pancreatic duct.