Pitfalls in MR cholangiopancreatographic interpretation

Hiroyuki Irie, Hiroshi Honda, Toshiro Kuroiwa, Kengo Yoshimitsu, Hitoshi Aibe, Kenji Shinozaki, Kouji Masuda

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Magnetic resonance (MR) cholangiopancreatography (MRCP) is widely used in the evaluation of pancreatobiliary disorders. However, numerous related pitfalls may simulate or mask pancreatobiliary disease. Maximum-intensity-projection (MIP) reconstructed images completely obscure small filling defects and may demonstrate respiratory motion artifacts. T2 weighting may vary with different MR imaging sequences and influence MRCP findings. Incomplete imaging may create confusion regarding ductal anatomy or disease. Furthermore, MRCP yields only static images and thus may fail to depict various anomalies. Limited spatial resolution makes differentiation between benign and malignant strictures with MRCP alone extremely difficult. Susceptibility artifacts may be caused by metallic foreign bodies or gastric-duodenal gas. Fluid accumulation may produce a pseudolesion or pseudostricture, although changing the imaging angle or section thickness may be helpful. Pneumobilia may be misinterpreted as bile duct stones, and true stones may be overlooked. Pulsatile vascular compression can cause pseudo-obstruction of the bile duct. Use of both source and MIP reconstructed images obtained from different angles can help avoid cystic duct-related pitfalls. Repeat MRCP or conventional MR imaging can help avoid pitfalls related to the periampullary region. Segmental collapse of the normal main pancreatic duct may be misinterpreted as stenosis, but administration of secretin is helpful. An awareness of these pitfalls and possible solutions is crucial for avoiding misinterpretation of MRCP images.

Original languageEnglish
Pages (from-to)23-37
Number of pages15
JournalRadiographics
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 1 2001

Fingerprint

Artifacts
Pathologic Constriction
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Magnetic Resonance Cholangiopancreatography
Cystic Duct
Secretin
Pancreatic Ducts
Cholestasis
Masks
Foreign Bodies
Bile Ducts
Blood Vessels
Anatomy
Stomach
Gases

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

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. https://doi.org/10.1148/radiographics.21.1.g01ja0523

Pitfalls in MR cholangiopancreatographic interpretation. / Irie, Hiroyuki; Honda, Hiroshi; Kuroiwa, Toshiro; Yoshimitsu, Kengo; Aibe, Hitoshi; Shinozaki, Kenji; Masuda, Kouji.

In: Radiographics, Vol. 21, No. 1, 01.01.2001, p. 23-37.

Research output: Contribution to journalArticle

Irie, H, Honda, H, Kuroiwa, T, Yoshimitsu, K, Aibe, H, Shinozaki, K & Masuda, K 2001, 'Pitfalls in MR cholangiopancreatographic interpretation', Radiographics, vol. 21, no. 1, pp. 23-37. https://doi.org/10.1148/radiographics.21.1.g01ja0523
Irie H, Honda H, Kuroiwa T, Yoshimitsu K, Aibe H, Shinozaki K et al. Pitfalls in MR cholangiopancreatographic interpretation. Radiographics. 2001 Jan 1;21(1):23-37. https://doi.org/10.1148/radiographics.21.1.g01ja0523
Irie, Hiroyuki ; Honda, Hiroshi ; Kuroiwa, Toshiro ; Yoshimitsu, Kengo ; Aibe, Hitoshi ; Shinozaki, Kenji ; Masuda, Kouji. / Pitfalls in MR cholangiopancreatographic interpretation. In: Radiographics. 2001 ; Vol. 21, No. 1. pp. 23-37.
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