Abstract
Magnetic resonance cholangiopancreatography (MRCP) has become a widely accepted noninvasive diagnostic tool in the assessment of pancreatic and biliary disease. MRCP essentially exploits extended T2 relaxation times of slow-moving fluid and delineates the outline of biliary and pancreatic ducts on T2-weighted images. In order to maximize the clinical implication of MRCP, it is of utmost importance for radiologists to optimize the acquisition technique, be aware of patient-related factors and physiologic changes than can affect its performance and interpretation. It is critical to understand the most common artifacts and pitfalls encountered during acquisition and interpretation of MRCP. We provide a general overview of the different pitfalls encountered in MRCP and pearls on how to manage them in real-world practice.
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Dooms GC, Fisher MR, Higgins CB, Hricak H, Goldberg HI, Margulis AR (1986) MR imaging of the dilated biliary tract. Radiology 158 (2):337-341. doi:https://doi.org/10.1148/radiology.158.2.3941860
Wallner BK, Schumacher KA, Weidenmaier W, Friedrich JM (1991) Dilated biliary tract: evaluation with MR cholangiography with a T2-weighted contrast-enhanced fast sequence. Radiology 181 (3):805-808. doi:https://doi.org/10.1148/radiology.181.3.1947101
Kang SK, Heacock L, Doshi AM, Ream JR, Sun J, Babb JS (2017) Comparative performance of non-contrast MRI with HASTE vs. contrast-enhanced MRI/3D-MRCP for possible choledocholithiasis in hospitalized patients. Abdom Radiol (NY) 42 (6):1650–1658. doi:https://doi.org/10.1007/s00261-016-1039-6
Irie H, Honda H, Kuroiwa T, Yoshimitsu K, Aibe H, Shinozaki K, Masuda K (2001) Pitfalls in MR cholangiopancreatographic interpretation. Radiographics 21 (1):23-37. doi:https://doi.org/10.1148/radiographics.21.1.g01ja0523
Griffin N, Charles-Edwards G, Grant LA (2012) Magnetic resonance cholangiopancreatography: the ABC of MRCP. Insights Imaging 3 (1):11-21. doi:https://doi.org/10.1007/s13244-011-0129-9
Zhu L, Wu X, Sun Z, Jin Z, Weiland E, Raithel E, Qian T, Xue H (2018) Compressed-Sensing Accelerated 3-Dimensional Magnetic Resonance Cholangiopancreatography: Application in Suspected Pancreatic Diseases. Invest Radiol 53 (3):150-157. doi:https://doi.org/10.1097/RLI.0000000000000421
Zhu L, Xue H, Sun Z, Qian T, Weiland E, Kuehn B, Asbach P, Hamm B, Jin Z (2018) Modified breath-hold compressed-sensing 3D MR cholangiopancreatography with a small field-of-view and high resolution acquisition: Clinical feasibility in biliary and pancreatic disorders. J Magn Reson Imaging 48 (5):1389-1399. doi:https://doi.org/10.1002/jmri.26049
Merkle EM, Nelson RC (2006) Dual gradient-echo in-phase and opposed-phase hepatic MR imaging: a useful tool for evaluating more than fatty infiltration or fatty sparing. Radiographics 26 (5):1409-1418. doi:https://doi.org/10.1148/rg.265055711
Eason JB, Taylor AJ, Yu J (2013) MRI in the workup of biliary tract filling defects. J Magn Reson Imaging 37 (5):1020-1034. doi:https://doi.org/10.1002/jmri.23847
Li X, Liu Y, Ren K, Xu R, Xu K (2011) Findings of bile flow artifacts on MR cholangiopancreatography. Chinese Journal of Radiology 45 (9):850-853
Sugita R, Sugimura E, Itoh M, Ohisa T, Takahashi S, Fujita N (2003) Pseudolesion of the bile duct caused by flow effect: a diagnostic pitfall of MR cholangiopancreatography. AJR Am J Roentgenol 180 (2):467-471. doi:https://doi.org/10.2214/ajr.180.2.1800467
Morita S, Ueno E, Saito N, Suzuki K, Machida H, Fujimura M, Maruyama K, Onodera Y, Watanabe K, Suzuki T, Ohnishi T, Imura C, Mitsuhashi N (2008) Frequency of common bile duct motion artifacts caused by inferior vena cava pulsation on magnetic resonance cholangiopancreatography. Magn Reson Med Sci 7 (1):31-36. doi:https://doi.org/10.2463/mrms.7.31
Watanabe Y, Dohke M, Ishimori T, Amoh Y, Okumura A, Oda K, Hayashi T, Hiyama A, Dodo Y (2000) Pseudo-obstruction of the extrahepatic bile duct due to artifact from arterial pulsatile compression: a diagnostic pitfall of MR cholangiopancreatography. Radiology 214 (3):856-860. doi:https://doi.org/10.1148/radiology.214.3.r00mr09856
Phisalprapa P, Prachayakul V (2013) Ascariasis as an unexpected cause of acute pancreatitis with cholangitis: a rare case report from urban area. JOP 14 (1):88-91. doi:https://doi.org/10.6092/1590-8577/1257
Yu M, Huang B, Lin Y, Nie Y, Zhou Z, Liu S, Hou B (2019) Acute obstructive cholangitis due to fishbone in the common bile duct: a case report and review of the literature. BMC Gastroenterology 19 (1):177. doi:https://doi.org/10.1186/s12876-019-1088-8
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Itani, M., Lalwani, N., Anderson, M.A. et al. Magnetic resonance cholangiopancreatography: pitfalls in interpretation. Abdom Radiol 48, 91–105 (2023). https://doi.org/10.1007/s00261-021-03323-1
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DOI: https://doi.org/10.1007/s00261-021-03323-1