American Journal of Roentgenology, Vol 170, 33-37, Copyright © 1998 by American Roentgen Ray Society

ARTICLES

Single-shot MR cholangiopancreatography of neonates, infants, and young children

T Miyazaki, Y Yamashita, Y Tang, T Tsuchigame, M Takahashi and Y Sera
Department of Radiology, Kumamoto University School of Medicine, Japan.

OBJECTIVE: This study was undertaken to assess the usefulness of MR cholangiopancreatography (MRCP) with a half-Fourier acquisition single- shot turbo spin-echo (HASTE) sequence as a noninvasive imaging technique to evaluate biliary or pancreatic disease in young children. SUBJECTS AND METHODS: We prospectively examined 45 children (mean age, 3 years) with MRCP using HASTE on a 1.5-T MR imaging unit. MRCP images were obtained in 1.4 sec without breath-hold. A body phased array coil and fat saturation technique were used for data collection. On the basis of the surgical (n = 19) and ERCP (n = 7) findings, clinical data, and follow-up observation, 21 children were deemed to have no significant abnormality. The other 24 children were found to have pancreaticobiliary disease, including congenital biliary atresia in five neonates, choledochal cyst in six infants, and anomalous connections between the bile and pancreatic ducts in four infants and nine young children. In children without abnormality, the MRCP images were graded for the depiction of normal structures. The findings obtained by MRCP were correlated with the surgical or ERCP results. RESULTS: HASTE MRCP showed the first branch of the intrahepatic duct, the common hepatic duct, the gallbladder, and the common bile duct in most children. In the 21 children with no abnormalities, the main pancreatic duct was visible in two of six neonates, in four of five infants, and in all 10 young children. The diagnostic accuracy of MRCP was 100% in patients with choledochal cysts, 100% in those with congenital biliary atresia, and 69% in those with anomalous connections between the bile and pancreatic ducts. CONCLUSION: MRCP using HASTE with a phased array coil is a noninvasive technique for revealing the pancreaticobiliary tract in young children.
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