To provide an overview of magnetic resonance cholangiopancreatography (MRCP) technique with relevant artefacts Correlate MRCP with endoscopic retrograde cholangiopancreatography (ERCP) findings, with additional relevant cross-sectional imaging so as to demonstrate : Normal biliary anatomy with relevant anatomical variants Biliary tree pathology e.g. gallstone disease, ductal strictures Pancreatic pathology

Technique MRCP is a non-invasive imaging technique that is essential in investigating pancreaticobiliary disorders. It relies on heavily T2 weighted pulse sequences to accentuate static fluid signal within structures such as the biliary tree which possess a long T2 relaxation time relative to surrounding soft tissues with shorter T2 relaxation times1. As such, these images provide relatively little anatomical detail. A comprehensive protocol will include additional (more anatomical) sequences for correlation and to complete the assessment. Intravenous contrast is not required and thus this technique...

NORMAL MRCP The biliary tree, gallbladder, common bile duct and pancreatic duct can be visualised (fig.1). ARTEFACTS Respiratory motion artefact degrades resolution and results in image “blurring” that poses significant difficulty in assessment of the biliary tree (fig.2). Artefact from surgical clips post-cholecystectomy (fig.3) poses a diagnostic challenge, giving the impression of signal void or perceived luminal narrowing. These can be mitigated by identifying other ancillary features of biliary obstruction such as the presence or absence of intra/extrahepatic ductal dilation. ANATOMICAL VARIANTS Pancreas divisum2 (fig.4)...

Radiologists are commonly required to interpret MRCP in both the acute and outpatient settings, with increasing frequency owing to the appealing characteristics of MRCP such as its non-invasive nature, the lack of ionising radiation and lack of intravenous contrast. A variety of pathologies and normal variants can be identified and it is essential to familiarise oneself with the MRCP appearances and potential pitfalls to avoid misdiagnosis. Familiarity with ERCP is also essential to allow the Radiologist to input into assessment of ERCPs e.g. with complex...

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