Role of Magnetic Resonance Cholangiopancreatography in Patients with Pancreatic Biliary Disease
MR cholangiopancreatography in pancreatic biliary disease
Background: Magnetic resonance imaging is helpful in evaluating pancreaticobiliary disease after preliminary screening by ultrasonography, instead of undergoing repeated ionizing radiation exposure or invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP) or transhepatic biliary procedures. Magnetic resonance Cholangiopancreatography (MRCP) is more sensitive in identifying lesions of cystadenomas and cystadenocarcinomas of the biliary tree. The present study was designed to evaluate the role of MRCP in Pancreaticobiliary diseases. Subjects and Methods: A hospital based Prospective Cross-sectional study was conducted in 50 patients with Pancreatico-biliary diseases using 3T whole-body MR system. Pancreatic, biliary diseases were evaluated on all the sequences. Results: Of the 50 patients, males and female ratio is 2.1:1, and the mean age was 45 years. Biliary anatomical variants are seen in 10 cases. Biliary congenital anomalies (Choledochal cysts) are seen in 3 cases. Biliary stone diseases are seen in 26(52%) cases. Out of 26 cases, 19(38%) patients showed cholelithiasis, and 7(14%) patients showed choledocholithiasis. Among the patients with biliary strictures (9), the most common are benign strictures observed in 7 patients, and the two are malignant. Distal CBD is most commonly involved than proximal CBD. Three pancreaticobiliary malignancies were identified, which were proved on histopathological examination. One case is hilar cholangiocarcinoma, one case is distal CBD cholangiocarcinoma and another case is carcinoma head of the pancreas. Conclusion: Most common cause identified in evaluating idiopathic acute pancreatitis is distal CBD stones suggesting acute gall stone pancreatitis. MRCP is a sensitive, very reliable non-invasive imaging that helps diagnose hepatobiliary disorders, predominantly in patients undergoing biliary enteric anastomosis, for knowing the level and extent of strictures. The diffusion-weighted sequence was helpful in characterizing the pancreatic neoplasms.
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