PURPOSE: To compare prospectively the data
provided with endoscopic retrograde cholangiopancreatography (ERCP) and
magnetic resonance (MR) cholangiopancreatography (MRCP) in eight patients
with symptomatic choledochal cysts. MATERIALS AND METHODS: Eight patients
(three children, five adults) with choledochal cyst and abdominal pain
underwent sequential single-shot turbo spin-echo T2-weighted MRCP and ERCP.
Seven of the eight patients had relapsing pancreatitis. In three patients,
a dynamic MR examination was performed after secretin stimulation of exocrine
pancreatic function. RESULTS: A complete correlation was observed between
ERCP and MRCP for defining the anatomic characteristics of the cyst (seven
type I cysts, one type IV cyst) and the presence of an abnormal pancreaticobiliary
junction (PBJ) (six patients) with a long common channel. Of the seven
patients with acute pancreatitis, six had an abnormal PBJ and one had common
bile duct (CBD) stones with a normal ductal union evidenced with both techniques.
In two patients, dynamic MRCP demonstrated preferential filling of the
gallbladder and the CBD after secretin injection, whereas normal duodenal
filling was observed in another patient without a junctional abnormality.
CONCLUSION: MRCP provides information equivalent to that provided with
ERCP, without potential complications, for the preoperative assessment
of choledochal cysts. Dynamic secretin-stimulated MRCP studies might help
better understand the pathophysiologic characteristics of this entity.
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