Magnetic resonance cholangiopancreatography (MRCP) is a safe and reliable non-invasive method of evaluating the bile ducts and pancreatic duct. Since its inception at Parkside MRI in 1995, MRCP exams have proven a highly accurate alternative to ERCP in patients with acute or recurrent abdominal pain.

MRCP exams do not utilize ionizing radiation and require no injection of contrast. The ductal anatomy is depicted using T2 weighted sequences that are sensitive to slowly moving fluid. Exams are performed using breath-hold techniques and typically last ten minutes or less.

MRCP exams at Parkside MRI have proven helpful in the following indications:

1. Assessment of biliary obstruction: Choledocholithiasis is the most common cause of biliary obstruction and up to 25% of patients scheduled for cholecystectomy are found to have stones in the common bile duct. Numerous studies have shown that sensitivity of MRCP for detection of common bile duct stones approaches 100%. MRCP is also accurate in assessing other causes of biliary obstruction such as chronic pancreatitis, malignant neoplasms or benign strictures.
2. Chronic pancreatitis: complications of chronic pancreatitis such as strictures of the pancreatic duct, pseudocysts and fistulas are well documented with MRCP.
3. Sclerosing cholangitis: MRCP is excellent for diagnosing the strictures and intraductal calculi associated with primary sclerosing cholangitis. It is also an accurate non invasive method of tracking the progression of disease.
4. Congenital ductal anomalies: the most common congenital anomaly of the pancreatic duct is pancreas divisum. This condition occurs when there is failure of fusion of the normal ventral and dorsal pancreatic ducts and may result in chronic pancreatitis and recurrent abdominal pain. MRCP is helpful in detection of pancreas divisum and of other congenital ductal anomalies such as choledochal cyst and annular panceas.
5. Abnormal liver function: MRCP can elucidate the cause of abnormal liver function in the asymptomatic patient especially when other imaging studies such as ultrasound are normal.

Click on any image below to see an enlargement of that image.

Case 1 Gallstones in gall bladder.	Case 2 Single shot 3 second breath hold image demonstrating gallstones in the gall bladder and common bile duct. Note that no contrast was necessary to acquire this image; sequence depicts fluid which is either stagnant or flowing slowly.

Above images are all original MR scans performed at Parkside MR Center.

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