Reuther G, Kiefer B, Tuchmann A, Pesendorfer F X
Abt. Bildgebende Diagnostik, Privatklinik und Ambulatorium Döbling, Wien.
Rofo. 1996 Dec;165(6):535-43. doi: 10.1055/s-2007-1015808.
Evaluation of utility and value of a selective projection technique for bile and pancreatic ducts in MRI.
200 patient examinations of the pancreaticobiliary duct system using a turbo-SE pulse sequence in "single-shot" technique were evaluated in retrospect concerning anatomic display and diagnostic accuracy compared to surgery, ERCP, i.v. cholangiography, ultrasound and clinical course.
Non-dilated ducts allowed visualisation of gallbladders in 78%, common bile ducts in 97%, cystic ducts in 80%, intrahepatic main ducts in 71% and pancreatic main ducts in 69%. When dilatation was present, all common bile, intrahepatic main and pancreatic ducts were visible. Display of cystic ducts and gallbladders with a detection rate of 69 and 85%, respectively, did not improve. Sensitivities for diagnosing papillary stenoses (n = 6), pancreatic ductal stenoses and dilatation (n = 13), compressions and dilatations of the biliary tree (n = 33) as well as for one choledochal cyst were 100%. Choledocholithiasis could correctly be predicted in 11/15 cases (73%), cholecystolithiasis in 71/120 cases (59%).
"Single-shot" MR-cholangiopancreatography is a fast and non-invasive modality which can replace i.v. cholangiography and restrict the indication for ERCP to therapeutic indications and problem cases.