DIAGNOSIS OF ANOMALOUS PANCREATICOBILIARY JUNCTION - VALUE OF MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY

Background. Anomalous pancreaticobiliary junction (a long common chann el), with or without congenital choledochal cyst, is frequently associ ated with biliary tract carcinoma. We assessed the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) for patients with anomalous pancreaticobiliary junction (PBJ). Methods. In 159 adult pat ients with pancreatobiliary disease, breath-hold (1 to 18 seconds) MRC P was performed according to a half-Fourier acquisition single-shot tu rbo spin-echo sequence. In all patients the length of the common chann el demonstrated by MRCP was compared with that demonstrated by endosco pic retrograde cholangiopancreatography. In 11 patients with anomalous PBJ (the common channel greater than or equal to 15 mm on endoscopic retrograde cholangiopancreatography), the diagnostic accuracy of MRCP for associated biliary diseases was evaluated. Results. No complicatio ns were encountered in performing MRCP. On MRCP, the length of the com mon channel was calculated to be 15 mm or longer In nine (82 %) of 11 patients with anomalous PBJ. In patients with normal PBJ, MRCP identif ied,PBJ with the channel measuring 0 mm in length. MRCP allowed detail ed visualization of congenital choledochal cyst (all seven patients) b ut failed to depict carcinoma (one patient) and mucosal hyperplasia (f ive patients) of the gallbladder. Conclusions. MRCP is a noninvasive a nd accurate imaging method for diagnosing anomalous PBJ and congenital choledochal cyst.