Cholangiopankreatografia rezonansu magnetycznego : normalna anatomia

Cholangiopankreatografia rezonansu magnetycznego (MRCP): obrazowanie i anatomia dróg żółciowych, pęcherzyka żółciowego i przewodu trzustkowego

Antoine MICHEAU, MD , Denis HOA, MD
Tytuły naukowe autorów
- Antoine MICHEAU, MD : 2 Allée Charles Darwin, 34170 Castelnau-le-lez
- Denis HOA, MD : 2 Allée Charles Darwin, 34170 Castelnau-le-lez
Data publikacji: 5 gru 2019 | Ostatnia aktualizacja 3 paź 2022
https://doi.org/10.37019/e-anatomy/688472.pl ISSN 2534-5079

This anatomical module of e-Anatomy is dedicated to the anatomy of the biliary tract on MRI on a MRCP (magnetic resonance cholangiopancreatography).

To emphasize our pedagogic goal in anatomy, we did not choose a healthy patient where the thin (not dilated) biliary tree may have been difficult to see on MRI, but a patient with dilated biliary tree (intrahepatic ducts and common bile duct) on a choledocholithiasis (gallstone) of the distal common bile duct.

Note that in the case displayed in this module, the patient presents a small anatomical variation of the biliary tree anatomy, type IIIA (the right posterior hepatic duct draining into the left hepatic duct (see diagram below)).

We perform a standard protocol of MRCP (magnetic resonance cholangiopancreatography) on a 1.5 T Siemens Aera:

Axial T2 HASTE: Axial breath-hold T2-weighted turbo spin-echo (TSE), 5 mm slices, on the whole biliary tract. Two breath-hold acquisitions are obtained so that the whole of the liver down to the duodenal ampulla is visualized.

MRCP thick slab (T2 weighted breath-hold HASTE fat-saturated thick slab): A fat saturated HASTE sequence where a single slab of data 4 cm in thickness is acquired in a 1- to 2-s breath-hold in 3 different coronal planes. MIP images have also been displayed.

Axial T2 HASTE 4 mm on CBD: An axial breath-hold T2-weighted turbo spin-echo (TSE), 4 mm slices only on the dilated common bile tract.

Axial T1 in-phase and axial T1 out-of-phase on the liver: Conventional abdominal MRI imaging to study extraductal structures (hepatic segments, pancreas, spleen, kidneys)

Axial T1 VIBE FS: A 3D fat suppressed T1-weighted GRE sequence without intravenous contrast administration to evaluate the duct walls, and any focal parenchymal pathology.

Coronal true FISP: This sequence is the first of our MRCP protocol, on the upper abdomen to establish the location of the extrahepatic bile ducts. But in this module of e-Anatomy, put it at the end because of its lack of relevant medical information on the biliary tract.