Specialty Procedures - MRCP

Since it introduction in 1991, MRCP has evolved to become a rapid, accurate and noninvasive means to evaluate the gallbladder, bile ducts and pancreatic ducts. Studies have shown it to be of equivalent accuracy to the more conventional invasive ERCP (endoscopic retrograde cholangiopancreatograpy) in its ability to detect stones, strictures and variant anatomy without the associated complications of ERCP.

It is typically performed in conjunction with routine abdominal MR imaging of the abdomen. New, rapid MR imaging techniques now available at Delta Radiology allow both to be performed with optimal patient comfort. It requires no injections or oral contrast material although patients are asked to remain free of oral intake for 4 hours prior to the procedure.

Indications for MRCP include:

  • Noninvasive screening of patients with low to intermediate probability of biliary stones. MRCP allows for the rapid and comfortable screening of such patients.
  • Failed or incomplete conventional ERCP. Approximately 10-20% of ERCP's cannot be completed for a variety of reasons. MRCP provides an excellent alternative.
  • Variant biliary duct anatomy. MRCP allows for the easy assessment for congential duct abnormalities that may cause symptoms or make laporoscopic surgery more difficult.
  • Evaluating post operative anatomy where ERCP would be difficult if not impossible.
  • Evaluating changes of chronic pancreatitis or sclerosing cholangitis.

Case Reports

A 12 year old girl without significant past medical history presented to the ER with epigastric pain and laboratory values suggesting pancreatic and biliary duct abnormalities. Initial CT was unremarkable. MRCP was requested to noninvasively evaluate the biliary system in this young patient.

The image below nicely demonstrates small gallstones in a dilated gallbladder as well as a distal common duct stone in a dilated common duct as the cause of symtoms. This information allowed for timely, appropriate surgical planning with excellent anatomic detail.

The below images demonstrate the excellent correlation between MRCP and intraoperative cholangiography in this 65 year male with clinical signs of biliary duct obstruction. Both display a large gallstone obstructing the distal common duct.

Health care personnel wishing to schedule an MRCP or discuss the procedure with an experienced radiologist are urged to contact Delta Radiology at 209-333-8343.