Radio-anatomic study of the pancreatic duct by MR cholangiopancreatography

Abstract

To compare the performance of MR-cholangiopancreatography (MRCP) and that of classical anatomy in the depiction of the main pancreatic duct, 50 MRCP examinations were done in patients free of pancreatic disease. Axial and coronal sections 20 mm thick were obtained in a Single Shot Fast Spin Echo (SSFSE) sequence. The following were analyzed: (1) visibility of pancreatic duct structures, (2) form of the main pancreatic duct, (3) various angulations of the duct and (4) diameter of the duct. Anatomic variants were noted. These findings were compared with anatomic and radio-anatomic (ERCP) data in the literature. The main pancreatic duct was visualized in 100% of cases and the accessory pancreatic duct in 61%. The form, diameter and angulations of the various segments of the pancreatic duct were similar to those reported in the literature. These findings are reported in the axial and coronal planes. Comparison with major anatomic classifications was not possible. MRCP enables in vivo anatomic exploration of the main pancreatic duct. Horizontal sections provided new radio-anatomic information. The technique nevertheless remains limited by poor spatial resolution.

Pancreatic Duct Patterns in Acute Pancreatitis: A MRI Study

“…The diameters found by MRI are most likely close to reality [24]. The diameter of the main pancreatic duct found in this study appears to be the same as that usually reported in the literature [24].…”

Pancreatic Duct Diversity

“…23,26,27 Pancreas divisum, for example, might be difficult to recognize during normal ERCP studies but can be easily diagnosed by MRCP. 5,22,23 Megibow et al 24 reported a high success rate of pancreas divisum diagnosis and assessment of ductal anatomy with the use of secretin stimulation during MRCP. This technique allows to visualize accessory pancreatic ducts without the necessity of endoscopic cannulation of the minor duodenal papilla.…”

“…14 Pancreas divisum is considered to be one of the possible normal anatomical variations by some authors. 5,22,23 A large series revealed a link between acute and chronic pancreatitis with different types of pancreas divisum. 6,24 The incidence of pancreatitis in pancreas divisum varies from 2.3% to 27.8%.…”

“…Furthermore, ERCP is usually performed in 1 position only without further reconstruction being possible. 23 Magnetic resonance cholangiopancreatography on the other hand, being a noninvasive procedure, allows to reconstruct the pancreatic ducts in several planes. 23,26,27 Pancreas divisum, for example, might be difficult to recognize during normal ERCP studies but can be easily diagnosed by MRCP.…”

“…23 Magnetic resonance cholangiopancreatography on the other hand, being a noninvasive procedure, allows to reconstruct the pancreatic ducts in several planes. 23,26,27 Pancreas divisum, for example, might be difficult to recognize during normal ERCP studies but can be easily diagnosed by MRCP. 5,22,23 Megibow et al 24 reported a high success rate of pancreas divisum diagnosis and assessment of ductal anatomy with the use of secretin stimulation during MRCP.…”