MRCP: Magnetic Resonance Cholangiopancreatography
Magnetic Resonance Cholangiopancreatography (MRCP) is a non-invasive alternative to conventional Endoscopic Retrograde Cholangiopancreatography (ERCP) for imaging of the pancreaticobiliary system. The study is performed using MRI, most optimally on high field systems (1.5T).
Indications:
- biliary disease and strictures
- primary sclerosing cholangitis
- choledocholithiasis
- acute and chronic pancreatitis
- neoplastic obstruction
- intraductal papillary mucinous tumor
- anatomic variants
- post-cholecystectomy complications
MRCP is now replacing diagnostic ERCP in many instances. The best use is for diagnosis in patients that are unlikely to need a therapeutic intervention possible with ERCP (e.g. stone retrieval, stricture dilation and stenting, etc.).
Advantages relative to ERCP:
- noninvasive and safe - no risk of potential ERCP complications from sedation or instrumentation such as pancreatitis, bile leak, hemorrhage, or sepsis
- better diagnostic sensitivity for duct stones
- visualization of adjacent extraluminal structures in addition to the ducts including tumor masses in liver or pancreas
- able to manipulate images in three dimensions
- no radiation
Disadvantages relative to ERCP:
- purely diagnostic - unable to perform interventions like stone removal, sphincterotomy, or biliary stenting
- images may be degraded if the patient is unable to lie still during the scan
- lower image resolution than ERCP.
MRCP exams are performed by SDI Radiologists on the high field (1.5T) MRI units at St. Joseph's Hospital and St. Joseph's Diagnostic Center (main campus only).
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