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magnetic resonance cholangiopancreatography (MRCP)
Indications:
1) evaluation of the hepatobiliary tree
- intra & extra hepatic bile ducts
- pancreatic duct
2) surveillance for cholangiocarcinoma
3) evaluation of pancreatic cysts & communication of cysts with pancreatic duct
4) distinguishing pancreatic cancer from chronic pancreatitis
5) can detect pancreas divisum
Contraindications:
- presence of metal (leads, surgical clips, shrapnel etc)
Procedure:
- does NOT require contrast material to be injected into the biliary system
- does NOT allow any intervention to be performed i.e. stone extraction, stent placement, biopsy
Compared with gold standard (ERCP)
1) sensitivity
a) 88% for malignancy
b) 92% for bile duct stones
c) 97% for presence of obstruction
d) 98% for level of obstruction
e) difficulty visualizing stones < 4 mm
f) difficulty evaluating
- small ampullary lesion
- primary sclerosing cholangitis
- strictures of bile ducts (vs spasm)
2) specificity: 95-98%
Related
endoscopic retrograde cholangiopancreatography (ERCP)
General
magnetic resonance imaging (MRI, diffusion-weighted MRI)
References
- Journal Watch 23(22):175, 2003
Romagnuolo J et al, Ann Intern Med 139:547, 2003
PMID: 14530225
- Barish MA et al.
Magnetic resonance cholangiopancreatography.
N Engl J Med 1999, 341:258
PMID: 10413739
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