magnetic resonance cholangiopancreatography (MRCP)

Indications

• evaluation of the hepatobiliary tree
  • intra & extra hepatic bile ducts
  • pancreatic duct
• surveillance for cholangiocarcinoma
• evaluation of pancreatic cysts & communication of cysts with pancreatic duct
• distinguishing pancreatic cancer from chronic pancreatitis
• 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)

• sensitivity
  • 88% for malignancy
  • 92% for bile duct stones
  • 97% for presence of obstruction
  • 98% for level of obstruction
  • difficulty visualizing stones < 4 mm
  • difficulty evaluating
    • small ampullary lesion
    • primary sclerosing cholangitis
    • strictures of bile ducts (vs spasm)
• specificity: 95-98%

More general terms

• magnetic resonance imaging (MRI, diffusion-weighted MRI)

Additional terms

• endoscopic retrograde cholangiopancreatography (ERCP)