title: Breath-hold magnetic resonance cholangiopancreatography in the evaluation of malignant pancreaticobiliary obstruction.
abstract: OBJECTIVE
  This study was designed to determine the effectiveness of magnetic resonance cholangiopancreatography (MRCP) using a breath-hold single-shot fast spin echo (SSFSE) technique in imaging patients with malignant biliary and/or pancreatic duct obstruction.
  
  
  METHODS
  One hundred thirty-one breath-hold MRCP studies in patients with malignant pancreatic and/or biliary obstruction were evaluated. Pathologic diagnoses included pancreatic cancer, biliary malignancy, gallbladder carcinoma, hepatic neoplasms, malignant lymphadenopathy, and ampullary carcinoma. Two observers independently reviewed the images in a blinded fashion to assess the level of obstruction and the site of underlying tumor.
  
  
  RESULTS
  The level of obstruction was correctly identified in 104 of 131 cases (79%) by observer 1 and in 107 of 131 cases (82%) by observer 2. The site of underlying tumor was correctly identified in 113 of 131 cases (86%) by observer 1 and in 110 of 131 cases (84%) by observer 2.
  
  
  CONCLUSIONS
  Magnetic resonance cholangiopancreatography utilizing the SSFSE technique can accurately assess the level of obstruction and the site of underlying tumor in patients with malignant pancreaticobiliary obstruction, without the risks of cholangiography. This MRCP technique allows for visualization of intra- and extraductal anatomy and pathology.
authors.affiliation: Department of Radiology, Memmorial Sloan - Kettering Cancer Center, and Weill Medical College of Cornell University, New York, NY 10021, USA. Schwartl@MSKCC.org
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lefkowitz
authors.forename: David M
authors.initials: DM
authors.lastname: Panicek
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Coakley
authors.forename: William
authors.initials: W
authors.lastname: Jarnagin
authors.forename: Ronald
authors.initials: R
authors.lastname: Dematteo
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.forename: Leslie
authors.initials: L
authors.lastname: Blumgart
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology*; D001661:Biliary Tract Neoplasms / Q000473:pathology; D002779:Cholestasis / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*