Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreatic duct trauma and its sequelae: Preliminary findings

Background: The purpose of this study was to determine the utility of magne tic resonance cholangiopancreatography (MRCP) in the evaluation of pancreat ic duct trauma and pancreas-specific complications. Methods: Ten hemodynamically stable patients with clinically suspected panc reatic injury related to blunt abdominal trauma (n = 8), penetrating trauma (n = 1), or iatrogenic trauma (n = 1) underwent MRCP. Two abdominal radiol ogists conducted a review of the MRCPs to assess for the presence or absenc e of pancreatic duct trauma and pancreas-specific complications such as pse udocysts, The MRCP findings were correlated with endoscopic retrograde chol angiopancreatograms (n = 2), surgical findings (n = 1), computed tomographi c scans (n = 10), and with clinical, biochemical or imaging follow-up (n = 10), Results: Diagnostic quality MRCPs were obtained in each of the 10 patients. A mean imaging time of 5 minutes was required to perform the MRCPs, Pancre atic duct injuries were detected in four patients; pseudocysts were detecte d in three of these four patients. The pancreatic duct injuries in three pa tients were acute or subacute, In one of the three patients, disruption of a side branch of the pancreatic duct diagnosed with MRCP was not detected w ith endoscopic retrograde cholangiopancreatography but was confirmed surgic ally. In the fourth patient, the pancreatic duct injury was chronic; MRCP r evealed a posttraumatic stricture in this patient who had sustained blunt a bdominal trauma 17 years previously. In the remaining six patients, pancrea tic duct trauma was excluded with MRCP. The information derived from the MR CPs was used to guide clinical decision-making in ail 10 patients. Conclusions: MRCP enables noninvasive detection and exclusion of pancreatic duct trauma and pancreas-specific complications and provides information t hat may be used to guide management decisions.