Single shot fast spin echo long TE magnetic resonance cholangio-pancreatography

Objectives - To assess the accuracy and reproducibility of a new magnetic r esonance cholangiopancreatography sequence (MRCP), using long echo time and "single shot" acquisition (providing high-contrast chick slices: 20 mm or more) in the morphological analysis of the biliary free and pancreatic duct s. Methods - Fifty four patients with biliary and/or pancreatic disease were i nvestigated with MRCP "single shot" chick slices. Biliary ducts were explor ed with MRCP "single shot", coronal and oblique coronal 20 mm thick slices on a 256 x 256 matrix. Natives pictures were reviewed by three independent radiologists, from three different institutions. MRCP results were compared with reference examinations in 54 cases (direct biligraphy methods: 54, CT scan: 11, endoscopic ultrasonography: 6, surgery: 6). Results - For defection of bile duct dilatation, the agreement of MRCP "sin gle shot" chick slices was more than 96% (Kappa > 0.92) and the inter-obser ver agreement was excellent (Kappa = 0.92). For detection of biliary tree a nd/or pancreatic duct obstruction, MRCP "single shot" chick slice sensitivi ty was above 89% and specificity was 75%. The malignant nature of the lesio ns was determined with a sensitivity of 100% and a specificity of 92%. MRCP "single shot" thick slices could not differentiate pancreatic carcinomas f rom distal main bile duct cholangiocarcinomas. MRCP single shot" thick slic es did not defect small stones (less than or equal to 3 mm) of the the comm on bile duct. Conclusion - The excellent sensitivity specificity and infer-observer agree ment of MRCP "single shot" thick slices can be used to limit invasive imagi ng methods in the diagnosis of extrahepatic cholestasis.