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MRCP Aliakbar Ameri –M.D. J. Jalal Shokouhi –M.D. Toktam Beheshtian –M.D. Didar Alaghband –M.D.

MRCP Aliakbar Ameri –M.D. J. Jalal Shokouhi –M.D. Toktam Beheshtian –M.D. Didar Alaghband –M.D. Susan Rafieian _M.D. And Ahmadreza Tahmaseb pour –M.D. In the past X-ray ,PTC ,ERCP ,T. tube CG Nowadays US ,CT ,CT PTC MRI ,MRCP ,Water imaging(STIR,T2,Fat sat.). Technic.

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MRCP Aliakbar Ameri –M.D. J. Jalal Shokouhi –M.D. Toktam Beheshtian –M.D. Didar Alaghband –M.D.

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  1. MRCP Aliakbar Ameri –M.D. J. Jalal Shokouhi –M.D. Toktam Beheshtian –M.D. Didar Alaghband –M.D. Susan Rafieian _M.D. And Ahmadreza Tahmaseb pour –M.D.

  2. In the past • X-ray ,PTC ,ERCP ,T. tube CG Nowadays • US ,CT ,CT PTC • MRI ,MRCP ,Water imaging(STIR,T2,Fat sat.)

  3. Technic

  4. Complications, Difficulties Incomplete ERCP Contrindications Technic: MRCP+ MRI of abdomen is complete assessment • 1.Heavy T2 ,Background sup. Fat Sat. • 2.Thick Reconstruction (3D) • 1.Thick slab (single shot fast spin) • 2.MIP

  5. Coronal Bilateral Oblique 4-8 cm thick slab 2-4 mm HASTE 1-2 Breath-Holds ,Respiratory triggering Negative oral contrast Not 100% need, duodenum is helpful Pineapple juice Secretin for virsung dynamics Mangafodipir (Tesla scan) 15-30 minutes after injection

  6. Indications: Clinically +90% , -10% • Biliary anomaly (choleducal cysts,…) • Trauma • Choleducolitiasis • Sclerosing cholangitis (MRCP > ERCP) Isolated Ulcerative colitis Retroperitoneal fibrosis Retro-orbital pseudotumor Cirrhosis Pancereatitis

  7. 5. Neoplasm 6. Pancreas a.Anomaly b.Pancereatitis (Stenosis , Dilation ,Beading of duct) (Stone , pseudocyst) c. Trauma d.Neoplasm

  8. Pitfalls in MRCP: 1. Pseudo stone (Air bubble) 2. Pseudo stenosis (Clip) Treatment: in phase and opposed phased 3. Cross compression of Rt. Hepatic artery 4. TOF of bile in CBD by HASTE Treatment: true FISP or balanced FFE 5. False negative for stone Stone impacted in ampula Fluid in Duo. ,GB ,stomach

  9. Results: 68 patients (28 men,40 women) 15-83 years old ,Mean : 48 years old Normal14 – GB stones 14 – CBD stones 10 – _ I.H. duct stones 6 – Sclerosing duct 6 – Hemosidrosis 1 _ Liver capsule fistula with ducts 1 – _Tumor 5 (met’s 3 , klot skin 2) – Virsung visualization 56+ , 12- ,Dilate in one case

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