Magnetic resonance cholangiopancreatography (MRCP) is a

medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to rev ...

technique. It uses

magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...

to visualize the

biliary A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic duct. It ...

and

pancreatic duct The pancreatic duct, or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct), is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancre ...

s non-invasively. This procedure can be used to determine whether

gallstone A gallstone is a calculus (medicine), stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to ...

s are lodged in any of the ducts surrounding the

gallbladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...

Uses

MRCP has been slowly replacing

endoscopic retrograde cholangiopancreatography Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skille ...

(ERCP) as investigation of choice. MRCP is highly accurate in diagnosing the

biliary system The biliary tract, (biliary tree or biliary system) refers to the liver, gallbladder and bile ducts, and how they work together to make, store and secrete bile. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and ...

and accessing surrounding solid organs. Several advantages offered by MRCP is its non-invasive nature, less costly, requires less examination time when compared to ERCP (30 minutes), fewer staff required, and does not require any ionising radiation. MRCP is used to diagnose

s. It can also diagnose

choledochal cysts Choledochal cysts (a.k.a. bile duct cyst) are congenital conditions involving cystic dilatation of bile ducts. They are uncommon in western countries but not as rare in East Asian nations like Japan and China. Signs and symptoms Most patients ha ...

very reliably. Besides providing information regarding the biliary system, MRCP also provides information regarding surrounding solid organs and blood vessels, thus useful for planning the resection of

pancreatic cancer Pancreatic cancer arises when cell (biology), cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a Neoplasm, mass. These cancerous cells have the malignant, ability to invade other parts of t ...

and look for complications of

primary sclerosing cholangitis Primary sclerosing cholangitis (PSC) is a long-term progressive disease of the liver and gallbladder characterized by inflammation and scarring of the bile ducts, which normally allow bile to drain from the gallbladder. Affected individuals may ha ...

such as

liver cirrhosis Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, and end-stage liver disease, is the impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease. Damage causes tissue repai ...

and

cholangiocarcinoma Cholangiocarcinoma, also known as bile duct cancer, is a type of cancer that forms in the bile ducts. Symptoms of cholangiocarcinoma may include abdominal pain, yellowish skin, weight loss, generalized itching, and fever. Light colored stool ...

Technique

Subject is needed to fast for at least four hours to ensure the biliary system is maximally distended with fluid while keeping the fluid in the gastrointestinal system at a minimum. However, clear fluid and routine medication is allowed before the scan. Negative oral contrast such as pineapple juice, date syrup, ferumoxsil, Açaí juice and water are useful in decreasing T2 signal intensity, thus minimising signals from stomach and duodenum from interfering with signals from the biliary system. MRCP makes use of heavily

T2-weighted Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. Physics of magnetic resonance imaging#MRI scanner, MRI scanners use strong magnetic ...

MRI

pulse sequence In Fourier transform NMR spectroscopy and imaging, a pulse sequence describes a series of radio frequency pulses applied to the sample, such that the free induction decay is related to the characteristic frequencies of the desired signals. After ...

s. These sequences show high signal in static or slow moving fluids within the gallbladder, biliary ducts and pancreatic duct, with low signal of surrounding tissue.

Secretin Secretin is a hormone that regulates water homeostasis throughout the body and influences the environment of the duodenum by regulating secretions in the stomach, pancreas, and liver. It is a peptide hormone produced in the S cells of the duode ...

is also given to a patient to increase ductal compliance, making imaging easier.

History

It was introduced by Wallner in 1991.

Additional images

3DPX-002306 Biliary tract MRCP Nevit Dilmen.stl, Benign biliary stricture. 3D File generated from MRCP 3DPrinted biliary system 20151201.jpg, 3D printed model of benign biliary stricture from MRCP data. MRCP normal.tif, Normal MRCP (with visible renal cyst)

References

Magnetic resonance imaging Digestive system imaging {{medical-equipment-stub

Uses

Technique

History

Additional images

See also

References