Evaluation of the pancreas: A comparison of single thick-slice MR cholangiopancreatography with multiple thin-slice volume reconstruction MR cholangiopancreatography

Abstract

OBJECTIVE. The purpose of this study was to assess abilities of single thick-slice MR cholangiopancreatography and multiple thin-slice multiprojection volume reconstruction (MPVR) MR cholangiopancreatography to evaluate diseases in and around the pancreas. SUBJECTS AND METHODS. Eighty- nine patients underwent both single and MPVR MR cholangiopancreatography using a single-shot fast spin-echo technique. Image quality (five-point scale), visualization of the common bile and pancreatic ducts (three-point scale), stenotic, dilatational, or cystic changes of the pancreatic ducts, and other pathologic findings were evaluated. RESULTS. Image quality was high for single and MPVR MR cholangiopancreatography (4.1 ± 0.7 and 4.5 ± 0.6, respectively). Misregistration was noted in 19 patients with MPVR MR cholangiopancreatography. Ducts on and around the greater duodenal papilla and the common bile duct were revealed better using MPVR than single MR cholangiopancreatography (p < .05). Overall sensitivity, specificity, and accuracy for detection of stenosis of the main pancreatic ducts were 83.3%, 93.6%, and 88.8%, respectively, using single MR cholangiopancreatography and 76.2%, 97.9%, 87.6%, respectively, using MPVR MR cholangiopancreatography. Dilatation of the pancreatic ducts (100%) and cystic changes (n = 17 and n = 19, respectively) were well seen using either single or MPVR MR cholangiopancreatography. Although stenotic changes of the nondilated main pancreatic ducts and their branches were difficult to evaluate using single (62.5% and 14.3%, respectively) or MPVR (43.8% and 21.4%, respectively) MR cholangiopancreatography, single MR cholangiopancreatography better depicted ductal continuity. CONCLUSION. For evaluation of the pancreas, single and MPVR MR cholangiopancreatography provide complementary data; thus, we recommend using a combination of these two MR cholangiopancreatography techniques.