MRcholangiopancreatografie

MR cholangiopancreatography (MRCP) is a noninvasive magnetic resonance imaging technique used to visualize the biliary tree and pancreatic duct system. It relies on heavily T2-weighted imaging to render static fluid bright, allowing ducts to be seen without intraluminal contrast. Most studies use a 3D heavily T2-weighted MRCP sequence with post-processing (such as maximum intensity projection) to provide a comprehensive view of the ducts. In some centers, secretin may be given to temporarily increase pancreatic ductal relaxation and enhance visualization.

Indications for MRCP include evaluation of obstructive jaundice, suspected choledocholithiasis (biliary stones), biliary strictures, pancreatitis, and congenital anomalies of the biliary or pancreatic ducts. It is also used in preoperative planning and in the assessment of ductal anatomy when ERCP or EUS is being considered.

Advantages of MRCP include its noninvasive nature, lack of ionizing radiation, and ability to visualize both the biliary and pancreatic ducts in a single session. It can detect ductal dilatation, stones, strictures, and extrinsic compressive lesions. Limitations include potential failure to detect very small stones, limited ability to characterize the cause of strictures (benign vs malignant), and susceptibility to motion or gas-related artifacts. MRCP cannot perform therapeutic interventions; if intervention is required, ERCP or EUS may be pursued.

Safety considerations are consistent with MRI: standard contraindications apply (ferromagnetic implants, severe claustrophobia). Conventional MRCP does not require gadolinium contrast, though contrast-enhanced liver MRI may be performed for additional information when indicated.