Magnetic resonance cholangiopancreatography of pancreaticobiliary duct dilation due to pancreatic carcinoma and chronic pancreatitis.

OBJECTIVE

To compare the findings of pancreaticobiliary duct dilation due to pancreatic carcinoma and chronic pancreatitis by magnetic resonance cholangiopancreatography (MRCP).

METHODS

MRCP findings in 28 cases of pancreatic carcinoma and 42 cases of chronic pancreatitis were retrospectively analyzed. Both plain MR and MRCP examinations were performed in all the cases after oral Gd-DTPA dilution.

RESULTS

MRCP in the patients with pancreatic carcinoma displayed dilated pancreatic duct with smooth and regular caliber (n=16, 72.7%), dilated common biliary duct with abrupt rupture in most cases (n=18, 90%) and intra- and extra-hepatic cholangiectasis (n=12, 42.8%), and the double-duct sign (n=19, 86.5%). In the patients with chronic pancreatitis, MRCP identified irregular dilation of the pancreatic duct across the whole segment of the lesion (n= 20, 60.6%), taper of the dilated common bile duct (n=8, 80%), stones within the pancreatic duct (n=5, 11.9%), and pancreatic pseudocsyt within the pancreatic duct (n=21, 50%).

CONCLUSION

Cholangiopancreatographic findings of pancreaticobiliary duct dilation are of great value in distinguishing pancreatic carcinoma from chronic pancreatitis.