MR Pancreatography: A Useful Tool for Evaluating Pancreatic Disorders

Magnetic resonance (MR) pancreatography is being used with increasing frequency as a noninvasive alternative to diagnostic endoscopic retrograde pancreatography in the evaluation of the pancreatic duct and various pathologic conditions of the pancreas. This recently developed technique allows improved spatial resolution and permits imaging of the entire pancreaticobiliary tract during a single breath hold. MR pancreatography can help identify the course and drainage pattern of the pancreatic duct and is useful in diagnosing congenital anomalies such as pancreas divisum and annular pancreas without the risk of inducing pancreatitis. In some instances, MR pancreatography may demonstrate duct disruption and associated fluid collections resulting from trauma. In recurrent acute pancreatitis, MR pancreatography is useful in suggesting the cause of the disease; in chronic pancreatitis, it is useful in depicting ductal anatomy, detecting strictures or intraductal calculi prior to surgery, and detecting complications such as pseudocysts and fistulas. In addition, MR pancreatography performed in conjunction with abdominal MR imaging is useful in identifying pancreatic malignancies as well as in establishing resectability and preventing unnecessary preoperative stent placement.