Introduction

Magnetic resonance cholangiopancreatography (MRCP), in use since the 1990s [1], is an accepted noninvasive imaging technique for the diagnosis of pancreaticobiliary diseases. MRCP images are created with the acquisition of heavily T2-weighted images, and can demonstrate the fluid-filled lumen of the biliary tree and the pancreatic duct with high signal intensity. It is comparable to endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of biliary-pancreas pathologic conditions [2–5]. The advantages of MRCP over other imaging techniques include (1) the examination is noninvasive and requires no anesthesia; (2) the examination is not operator dependent, and high-quality images can be obtained consistently; (3) no administration of intraductal or intravenous contrast agent is necessary; (4) no ionizing radiation is used; (5) visualization of ducts proximal to an obstruction is superior to that achieved by ERCP; (6) MRCP can be successfully performed in the presence of biliary–enteric anastomoses; and (7) combination with conventional MR sequences is possible and helpful for the evaluation of duct wall and extraductal disease [6]. For many years, ERCP has been considered the standard of reference for imaging the biliary tract and pancreatic duct owing to its higher spatial resolution and potential for image-guided therapy [7]. However, it has a reported complications rate of up to 5% including duodenal perforation, pancreatitis, bleeding and sepsis [8]. For all of these reasons, MRCP has replaced diagnostic ERCP in the last few years, unless an intervention or tissue sampling is required [9].