[Magnetic resonance cholangiopancreatography. A new method of noninvasive biliopancreatic diagnosis].

Magnetic Resonance cholangiopancreatography (MRCP) is a new noninvasive imaging technique for the visualization of the biliary ducts with cholangiographic images similar to those obtained with ERCP and PTC, but with no contrast agent injection. In this paper, we report on our preliminary experience with a mild-field strength magnet (0.5T) and TSE sequences, acquired with respiratory compensation. The images were compared with ERCP images to compare diagnostic quality. Eighteen patients were examined: the biliary tract was dilated because of chronic pancreatitis in 3 patients, because of choledochal stones in 9, of carcinoma of the pancreatic head in 4, of lymphadenopathy in one patient. A patient submitted to choledochoduodenostomy and waiting for cholecystectomy was also examined. MRCP was performed with a superconductive magnet at 0.5T. Volumetric images on coronal planes were acquired; a T2-weighted TSE sequence (TR = 5000, TE = 244, Nex = 4, ETL = 45; acquisition time = 14 min 10 s) with respiratory compensation was also performed. The images were reconstructed on coronal planes at different angles with the MIP algorithm. All patients were then submitted to ERCP and one to PTC. In all patients, the intrahepatic biliary tracts, hepatic ducts and choledochus were completely demonstrated, with very good image quality in 16 cases and good in 2. The Wirsung duct was always visualized in all the 9 patients with mild to severe dilation. In conclusion, MRCP can be considered a valuable alternative to diagnostic ERCP. Further studies are necessary for better assessment of the potential advantages and pitfalls of this technique.