[Cholangiopancreatography with magnetic resonance in the assessment of pancreatic ducts]

We investigated MR cholangiopancreatography (MRCP) findings in patients with pancreatic conditions, which are mainly diagnosed based on US and CT morphologic findings. Sixty-three patients were submitted to MRCP using a .5T magnet. MRCP was performed with non-breath-hold fat-suppressed 3D turbo spin echo sequences (TR = 3000 ms, TE = 700 ms, ETL = 128, NEX = 6) with 3 min acquisition time. For better depiction of Wirsung duct and secondary ducts in the last 11 patients, a high resolution technique with a 128 x 256 matrix, 8 NEX and 8 min 36 s acquisition time was developed. MRCP images were studied both on MIP reconstructions and on single slices as well as T1- and T2-weighted TSE axial images. The diagnosis was compared with endoscopy, percutaneous procedure or CT findings in all cases. A hypointense focal mass was observed on T1-weighted TSE images in 39 pancreatic carcinoma patients (100%) and parenchymal atrophy was shown in 13 patients (33%); a sudden obstruction of the Wirsung duct was observed in 16 cases (41%) with homogeneous dilatation in 11 cases (28%). A tapered appearance of the distal Wirsung duct was demonstrated in 19 chronic pancreatitis patients, with diffuse patchy signal changes in 12 patients (63%); bead-like appearance of the Wirsung duct was shown in 6 cases (32%) and pseudocysts in 7 cases (37.3%). MRCP is the only imaging method demonstrating pancreatic conditions between carcinoma and pancreatitis, similarly to ERCP.