Zeina Abdel-Rauf, Shibolet Oren, Garra Mohamed, Taher Randa, Gal Oren, Oster Michael, Hazzan Rawi, Mahamid Ahmad, Abu Baker Fadi
Department of Radiology, Hillel Yaffe Medical Center, Hadera 38100, Israel.
Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3525433, Israel.
J Clin Med. 2025 Aug 23;14(17):5962. doi: 10.3390/jcm14175962.
Magnetic Resonance Cholangiopancreatography (MRCP) has continuously evolved to enhance visualization capabilities. However, diagnosing biliary ductal system pathology, particularly early primary sclerosing cholangitis (PSC), remains challenging. This study investigates the influence of intramuscular glucagon (IMG) administration on final image quality and pancreatobiliary ductal system diameter in MRCP. Forty patients (57.5% female; average age 34.45 ± 8.2) referred for Magnetic Resonance Enterography (MRE) underwent MRCP before and 8-12 min after IMG administration. Two independent MRI specialists analyzed Coronal T2-weighted fast spin-echo high-resolution 3D MRCP images quantitatively and qualitatively. Quantitative assessments involved measuring the transverse diameter of five specific biliary duct structures (inferior, mid, and upper common bile duct; right and left hepatic ducts) and three pancreatic duct segments (head, body, and tail). The qualitative evaluation used a five-point Likert-type scale (1 = perfect visualization; 5 = not visible) for the predefined segments. Interobserver variation was assessed using the Intraclass Correlation Coefficient (ICC). Following IMG administration, the diameters of all corresponding biliary and pancreatic segments significantly increased, with consistently strong interobserver agreement demonstrated pre- and post-IMG administration. Moreover, in qualitative analysis, post-IMG administration scores indicated a significant decrease ( < 0.01) in visualization scores, signifying improved visualization at all corresponding points for both radiologists compared to the pre-glucagon administration scores. The ICC scores pre- and post-IMG administration demonstrated moderate to strong agreement. IMG administration improves MRCP imaging parameters by increasing ductal diameters and enhancing biliary tree visualization, underscoring its potential to detect subtle or early pathological changes.
磁共振胰胆管造影（MRCP）一直在不断发展以增强可视化能力。然而，诊断胆管系统病变，尤其是早期原发性硬化性胆管炎（PSC），仍然具有挑战性。本研究调查了肌内注射胰高血糖素（IMG）对MRCP最终图像质量和胰胆管系统直径的影响。40例因磁共振小肠造影（MRE）前来检查的患者（女性占57.5%；平均年龄34.45±8.2岁）在注射IMG前及注射后8 - 12分钟接受了MRCP检查。两名独立的MRI专家对冠状面T2加权快速自旋回波高分辨率3D MRCP图像进行了定量和定性分析。定量评估包括测量五个特定胆管结构（胆总管下部、中部和上部；右肝管和左肝管）和三个胰管节段（胰头、胰体和胰尾）的横径。定性评估使用五点李克特量表（1 = 完美可视化；5 = 不可见）对预定义节段进行评分。观察者间差异使用组内相关系数（ICC）进行评估。注射IMG后，所有相应胆管和胰管节段的直径均显著增加，在注射IMG前后观察者间均表现出高度一致。此外，在定性分析中，注射IMG后的评分显示可视化评分显著降低（<0.01），这表明与注射胰高血糖素前的评分相比，两位放射科医生在所有相应点的可视化效果均有所改善。注射IMG前后的ICC评分显示出中度至高度一致。注射IMG通过增加导管直径和增强胆管树可视化来改善MRCP成像参数，突出了其检测细微或早期病理变化的潜力。
