NONINVASIVE CHOLANGIOPANCREATOGRAPHY BY BREATH-HOLD MAGNETIC-RESONANCE-IMAGING - PRELIMINARY-RESULTS

Aims: A preliminary comparison of a prototype breath-hold magnetic res onance cholangio-pancreatography (MRCP) technique for non-invasive ima ging of the pancreatic and biliary ducts with endoscopic retrograde ch olangio-pancreatography (ERCP). Method: Twenty ERCP and MRCP examinati ons mere performed in 19 patients referred for routine ERCP with suspe cted biliary or pancreatic abnormalities, The MRCP technique employed a modified heavily T2-weighted thick slice RARE sequence that allowed up to three images to be obtained in a 16 second breath-hold, The exam inations were reported independently and the findings compared. Result s: MRCP accurately discriminated between patients without obstruction (it = 12) and those with (n = 8) and correctly diagnosed the cause of obstruction (three choledocholithiasis, five malignant stricture), In the 12 patients without obstruction the examinations were concordant i n eight, In the remaining four patients MRCP provided more information than the corresponding ERCP study, diagnosing a pseudocyst in one pat ient and visualizing the entire pancreatic duct in three patients in w hom this was not possible at ERCP. Conclusions: These preliminary resu lts suggest that a breath-hold MRCP technique may allow the selection of those patients with obstructive lesions that require therapeutic ER CP intervention, and may have the potential to reduce the need for dia gnostic ERCP examinations.