Magnetic resonance (MR) imaging and MR cholangiopancreatography are useful,
noninvasive techniques for the assessment of pancreatic and hepatobiliary
complications in cystic fibrosis. Abnormalities of the pancreas in cystic f
ibrosis are typically characterized by fat deposition, which has increased
signal intensity on T1-weighted MR images, and pancreatic fibrosis, which h
as low signal intensity on both T1- and T2-weighted images. Pancreatic cyst
s are a relatively common finding; these cysts are typically quite small bu
t are well demonstrated at MR imaging and MR cholangiopancreatography. Panc
reatic duct abnormalities are also occasionally seen. Hepatic manifestation
s range from hepatomegaly and diffuse fatty infiltration to severe cirrhosi
s with fibrotic change, regenerative nodules, and portal hypertension. Sple
nomegaly is often characterized by siderotic nodules that manifest as multi
ple focal areas of abnormal low signal intensity within the spleen. Biliary
manifestations include cholelithiasis, stricturization, and narrowing or d
ilatation of intra- and extrahepatic bile ducts. Gallbladder abnormalities
including microgallbladder are also readily demonstrated. MR cholangiopancr
eatography can be used to help determine the presence and severity of bilia
ry complications without resorting to more invasive procedures and, in conj
unction with MR imaging, may prove useful in the assessment of patients wit
h cystic fibrosis who present with abdominal symptoms that suggest hepatobi
liary involvement.