ABSTRACT
The clinical value of using MRCP is similar to that of diagnostic direct cholangiopancreaticography and in most instances; MRCP will gradually replace direct cholangiopancreaticography and provide an efficient alternative when diagnostic ERCP or PTC is unsuccessful or inadequate. The aim of this study is to evaluate the role of MRCP as a non invasive technique in the diagnosis of malignant biliary obstruction. This study was conducted on 22 patients, 13 males and 9 females and their age ranged between 22 and 70 years with a mean age of 44.6 years. All patients were subjected to: complete clinical examination, laboratory investigations and radiological investigations including MRCP. MRCP as well as complementary axial and coronal T2 W MR images were performed to make prospective diagnosis in 22 patients with suspected pancreatico-biliary tumors. MRCP was performed using, breath- hold 2D singleslice FSE and non breath- hold multi-slice acquisition followed by 3D MIP reconstruction. Patients in this study included 13 cases of cholangiocarcinoma, 3 cases of hepatocellular carcinoma [HCC] causing biliary obstruction, 3 cases of pancreatic head carcinoma, 2 cases of periampullary carcinoma and one case of portahepatis lymphadenopathy causing biliary obstruction. The accuracy of MRCP as well as axial and coronal T2W MR images in diagnosing patients with pancreaticobiliary tumors was [100%]. MRCP could detect level of biliary obstruction which was intrahepatic, hilar, extrahepatic or periampullary. MRCP could also assess degree of proximal biliary ductal dilatation. MRCP as well as complementary axial and coronal T2 WI could define organ of tumor origin and extent of invasion of the malignant lesion. MRCP as well as complementary axial and coronal T2 W MR images are considered a non invasive accurate method in the diagnosis of pancreaticobiliary tumors and in assessing the level of biliary obstruction, degree of biliary ductal dilatation, organ of tumor origin and the extent of tumor invasion