Makindo Medical Notes

Traditionally, Endoscopic Retrograde Cholangiopancreatography (ERCP) was used to investigate choledocholithiasis, but it is an invasive procedure with risks such as perforation, pancreatitis, and, in rare cases, death. As a result, Magnetic Resonance Cholangiopancreatography (MRCP) has become the preferred diagnostic modality due to its non-invasive nature.

About MRCP

• MRCP is a medical imaging technique that uses MRI to visualize the biliary and pancreatic ducts in a non-invasive manner.
• It is particularly useful for detecting gallstones lodged in the ducts surrounding the gallbladder.
• MRCP can also evaluate the liver, gallbladder, bile ducts, pancreas, and pancreatic ducts for signs of disease without using ionizing radiation.

Techniques

• May involve the use of intravenous (IV) contrast agents, such as gadolinium, to enhance the imaging.
• The scan typically takes around 40 minutes to complete.

Indications for MRCP

• Acute gallstone pancreatitis, to assess for choledocholithiasis (stones in the common bile duct).
• Suspected common bile duct stones or gallstones.
• Diagnosis and evaluation of sclerosing cholangitis.
• Assessment of biliary tree cancers.
• Investigation of other causes of pancreatitis.

Contraindications

• Generally avoided during the first trimester of pregnancy unless the benefits clearly outweigh the potential risks.
• Gadolinium contrast should not be administered to pregnant women unless absolutely necessary.
• Patients with pacemakers, implantable cardioverter-defibrillators (ICDs), metallic fragments, cochlear implants, or certain vascular clips may not be eligible for MRI.