Objective: Magnetic resonance cholangiopancreatography (MRCP) enables a non-invasive evaluation of the anatomy and pathology of the pancreaticobiliary system rapidly, reliably, and without complications without using contrast agents. This research aimed to elucidate the routine use of MRCP imaging in emergency departments (EDs) and help patients receive more precise and rapid diagnoses in shorter periods.
Material and Methods: This retrospective cross-sectional study included 368 patients who applied to the ED and underwent MRCP. An expert radiologist with at least 5 years of experience evaluated MRCP imaging. The images were examined based on choledocholithiasis, gallstone, bile sludge, biliary duct dilatation and cholecystitis, gallbladder perforation, acute pancreatitis, and tumor. The demographic characteristics of the patients, imaging indications, and bilirubin values were analyzed.
Results: MRCP examination revealed cholecystitis in 53.0% (n=195) of the patients, gallbladder perforation in 1.4% (n=5), acute pancreatitis in 22.0% (n=81), and gallbladder or goatskin tumor in 11.4% (n=42). None of these pathologies was found in 32.6% (n=120). Regarding gender, MRCP findings, imaging method and indications, and bilirubin grades based on four MRCP diagnoses, cholecystitis was detected in 57.8% of patients with choledocholithiasis, while the tumor was detected in only 5.8% (p=0.004). Most patients with gallstone were diagnosed with cholecystitis (70.9%), while cancer was diagnosed in only 8.5% of patients (p<0.001 and p=0.036, respectively). Biliary duct dilatation was the most common finding in patients with tumors. There was no significant difference between MRCP findings, diagnoses, and bilirubin grades in all three imaging options. Tumoral formations were detected more in patients with high bilirubin levels, while acute pancreatitis was more in patients with low bilirubin levels (p<0.05).
Conclusion: MRCP is a non-invasive , ionizing, radiation-free, complication-free, contrast-free, and premedication-free examination method with as high an accuracy rate as endoscopic retrograde cholangiopancreatography in pancreaticobiliary diseases.
Keywords: Magnetic resonance cholangiopancreatography (MRCP), pancreaticobiliary disease, cholecystitis, tumors
