Can MRCP replace ERCP?

Abstract

Magnetic resonance cholangiopancreatography (MRCP) has replaced direct cholangiography and pancreatography in many instances. Its complete noninvasiveness and flexibility are less onerous for patients. For the use of screening as well as scrutiny, MRCP has played an important role in diagnosing various pathologies in this field. The usefulness of MRCP is not limited to anatomical evaluations; it can also yield physiologic and functional information. From a cost-performance basis, MRCP is undoubtedly superior to direct methods. Coupled with a cutting-edge MR system, MRCP has the potential to limit the use of invasive transpapillary and percutaneous methods merely to interventional purposes. In the near future, the emergence of interventional MR scanners will make MRCP even more competitive, and the replacement will be accelerated.

A systematic review and economic evaluation of magnetic resonance cholangiopancreatography compared with diagnostic endoscopic retrograde cholangiopancreatography

“…The advent of FSE sequences has shortened imaging time significantly. 36 These are rapid acquisition and relaxation enhancement (RARE) techniques. The acquisition of data and the filling of K-space has allowed these sequences to become breath-holding using half-Fourier methods to fill K-space, for example in the half-Fourier single-shot turbo spin echo (HASTE) sequence.…”

Management of severe acute pancreatitis

“…Several studies comparing CT with MRCP have shown that the latter is safe and as good as, if not better than, CT for both diagnosing and grading severe acute pancreatitis 63 -66 . The benefits of MRCP include images of superior resolution without the use of ionizing radiation or large volumes of iodinated contrast media 67,68 . However, a number of problems may be encountered, mainly owing to prolonged scan times, including breathing artefacts, bowel peristalsis and vascular motion artefacts, and gastrointestinal air and metallic clips creating susceptibility artefacts, all of which serve to degrade image quality 69 .…”

“…However, a number of problems may be encountered, mainly owing to prolonged scan times, including breathing artefacts, bowel peristalsis and vascular motion artefacts, and gastrointestinal air and metallic clips creating susceptibility artefacts, all of which serve to degrade image quality 69 . It should be appreciated, however, that MRCP is still evolving and the results are expected to improve with increasing experience and faster equipment 67 .…”

A Comparative Study of Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography

“…Biliary strictures are also not visualised directly on CT. ERCP and PTC are invasive imaging modalities. 3 MRCP since its introduction by Wallner et al in 1991 has experienced remarkable growth in the diagnosis of biliary diseases. It has now assumed the position of modality of choice in the evaluation of biliary tree and pancreatic duct.…”