Magnetic resonance cholangiopancreatography in cystic lesions of the pancreas

There are few reports about magnetic resonance cholangiopancreatography (MR CP) in cystic lesions of the pancreas (KLP). For this reason, we have under taken a prospective study evaluating the diagnostic efficiency of MRCP as c ompared with ultrasonography. Twenty-four patients with KLP were examined w ith magnetic resonance imaging (MRI), and standard and cholangiopancreatogr aphy. There were seven cases of cysts associated with acute pancreatitis, 1 1 patients with KLP and chronic calcifying pancreatitis, five cases of cyst ic neoplasms of the pancreas, and one polycystic disease of the gland. All cases were first submitted to ultrasonography, which failed to diagnose onl y a case of cyst associated with chronic pancreatitis depicted by MRCP. We used a GE Signa Horizon 1.5-T system (20 examinations) and a Siemens Magnet on Plus 1.5-T machine (four examinations). Eleven patients were operated on . In all cases, it was possible to identify the cysts, the main pancreatic duct and the biliary tree, and verify the relationship of the cyst with nei ghboring organs. Communication of the cyst with the main pancreatic duct wa s described in five instances, but we cannot be sure that MRCP would have d epicted all cyst-duct communications. The MRI and MRCP images were confirme d by surgery in the 11 operated-on cases. The diagnosis of duct alterations and small pancreatic stones in initial cases of chronic calcifying pancrea titis may be problematic. Clinical findings are very important data to be c onsidered in the differential diagnosis of KLP. Together with the clinical data, MRCP is a very important technique in the diagnostic and therapeutic decision making of KLP. Standard magnetic resonance is advisable as part of the examination in all cases. MRCP is not invasive, is reliable if one kno ws its limitations, and the patient can return at once to his activities. I t allows the analysis of many variables in one examination, contributing to better therapy.