Difficult Choices in Biliary Imaging: MRCP & Contrast Agents
JeongHee Yoon1
1Seoul National University Hospital, Seoul, Korea, Republic of

Synopsis

MRI including MRCP is a non-invasive modality to evaluate the bile duct.

Target audience

Radiologists and scientists who are interested in biliary imaging

Summary

MRCP is a non-invasive modality to evaluate the bile duct. Roughly, MRCP is classified into two categories- T2-weighted and T1-weighted ones. T2-weighted MRCP is further divided into 2D and 3D MRCP, depending on the acquisition schemes. Compared with 2D MRCP, 3D T2 MRCP provides higher spatial resolution and better signal-to-noise ratio, it often suffers from motion artifact, especially in patients with irregular breathing patterns. Recent technical development contributes to reduce the scan time of 3D T2 MRCP in a single breath-hold. With regard to the T1 MRCP, the image quality has been improved by implementing small FOV imaging, high flip angle, and compressed sensing. In addition, the information on the biliary excretion helps to figure out the presence or absence of bile duct injury or obstruction. To obtain the T1 MRCP, hepatocyte-specific contrast agent should be used, so the advantages and disadvantages of hepatocyte-specific contrast agent will be discussed in several clinical scenarios.

Takeaway messages

  • With technical development, 3D T2 MRCP can be achieved within a single breath-hold.
  • Breath-hold 3D T2 MRCP provides sufficient image quality consistently, and reduces the incidence of scan failure.
  • T1 MRCP using EOB offers high temporal, spatial and contrast resolution images in addition to the functional information of biliary excretion.
  • Clinical situations should be considered to determine the types of MRCP and MRI protocols.

Acknowledgements

None

References

None
Proc. Intl. Soc. Mag. Reson. Med. 29 (2021)