Abstract
Background and Study Aims: The present study tries to evaluate the success rate of MRCP when two attempts by
experts to perform ERCP in a center failed.
Patients and Methods: From March 1996 to December 1996 thirteen patients fulfilled the inclusion criteria.
The MR cholangiopancreatograms were acquired using commercially available software
in a clinical MR scanner (Magnetom Expert 1 T-Scanner, Siemens, Erlangen, Germany).
MRCP utilized heavily T2-weighted turbospin echo sequences with fat supression (HASTE).
Maximum intensity projection (MIP) of the pancreatic duct and biliary tree was then
carried out. Additionally, T1-weighted sequences were obtained using the breath-hold
technique.
Results: The MRCP images were of diagnostic quality in all 13 patients. In five cases the
diagnoses detected by MRCP were followed by an interventional procedure. One patient
showed a pancreatic pseudocyst, that was percutaneously drained using ultrasound guidance.
In three cases we found benign bile duct obstruction, all of which were successfully
treated by percutaneous transhepatic drainage. In one patient choledocholithiasis
was diagnosed, the stone was successfully managed by percutaneous transhepatic extraction.
Conclusion: MRCP is the method of choice in cases where ERCP is incomplete or where duct cannulation
is not possible. A further advantage of MR imaging is the fact that it may provide
complementary information about the whole region of interest, thus detecting the cause
of duct pathology in many cases.
