Normal Vaterian sphincter complex: evaluation of morphology and contractility with dynamic single-shot MR cholangiopancreatography.
OBJECTIVE
The objective of this study was to assess the usefulness of dynamic single-shot MR cholangiopancreatography in the evaluation of the morphology and contractility of the normal Vaterian sphincter complex and to assess whether i.v. injection of glucagon can improve visualization.


METHODS
Sixty patients without signs of Vaterian sphincter complex dysfunction were studied. A fast single-shot MR imaging sequence was used to obtain 20 consecutive images of the Vaterian sphincter complex during successive episodes of breathholding. In patients of group A (n = 30), 10 images were obtained before and 10 after i.v. administration of a sphincter-relaxing agent (glucagon). In the patients of group B (n = 30), no glucagon was administered. The degree of visualization of the Vaterian sphincter complex was assessed.


RESULTS
Overall, the morphology and contractility of the Vaterian sphincter complex was adequately assessed in 57 patients (95%). However, the number of repetitions required to obtain this result varied greatly (mean, seven; range, two to 18). Glucagon had no apparent effect on the visibility of the most distal portion of the common bile duct.


CONCLUSIONS
Nonvisualization of the most distal portion of the common bile duct on MR cholangiopancreatography studies is a normal variant that can simulate disease. Obtaining serial breath-hold images using a single-shot technique is helpful to avoid diagnostic errors.
Van Hoe
L
L
Department of Radiology, University Hospitals Gasthuisberg, Leuven, Belgium.
Gryspeerdt
S
S
Vanbeckevoort
D
D
De Jaegere
T
T
Van Steenbergen
W
W
Dewandel
P
P
Baert
A L
AL
Marchal
G
G
D000328:Adult; D014670:Ampulla of Vater / Q000033:anatomy & histology* / Q000187:drug effects / Q000502:physiology; D001652:Bile Ducts / Q000033:anatomy & histology; D005260:Female; D005934:Glucagon / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D010179:Pancreas / Q000033:anatomy & histology
D005934:Glucagon