BACKGROUND: Anomalous pancreaticobiliary
junction (a long common channel), with or without congenital choledochal
cyst, is frequently associated with biliary tract carcinoma. We assessed
the diagnostic value of magnetic resonance cholangiopancreatography (MRCP)
for patients with anomalous pancreaticobiliary junction (PBJ). METHODS:
In 159 adult patients with pancreatobiliary disease, breath-hold (1 to
18 seconds) MRCP was performed according to a half-Fourier acquisition
single-shot turbo spin-echo sequence. In all patients the length of the
common channel demonstrated by MRCP was compared with that demonstrated
by endoscopic retrograde cholangiopancreatography. In 11 patients with
anomalous PBJ (the common channel > or = 15 mm on endoscopic retrograde
cholangiopancreatography), the diagnostic accuracy of MRCP for associated
biliary diseases was evaluated. RESULTS: No complications were encountered
in performing MRCP. On MRCP, the length of the common channel was calculated
to be 15 mm or longer in nine (82%) of 11 patients with anomalous PBJ.
In patients with normal PBJ, MRCP identified PBJ with the channel measuring
0 mm in length. MRCP allowed detailed visualization of congenital choledochal
cyst (all seven patients) but failed to depict carcinoma (one patient)
and mucosal hyperplasia (five patients) of the gallbladder. CONCLUSIONS:
MRCP is a noninvasive and accurate imaging method for diagnosing anomalous
PBJ and congenital choledochal cyst.
rie H; Honda H; Jimi M; Yokohata K; Chijiiwa
K; Kuroiwa T; Hanada K; Yoshimitsu K; Tajima T; Matsuo S; Suita S; Masuda
K Value of MR cholangiopancreatography in evaluating choledochal cysts.
AJR Am J Roentgenol 1998 Nov;171(5):1381-5
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