Pancreaticobiliary Juice Reflux in Patients With a Morphologically Normal Ductal System: Assessment Using Unenhanced MRI With Spin Labeling.
OBJECTIVE
The purpose of this article is to evaluate pancreaticobiliary reflux and to assess its correlation with clinical findings in patients without morphologic pancreaticobiliary maljunction by using a new MRI technique.


METHODS
A total of 320 consecutive patients with suspected pancreaticobiliary diseases underwent MRCP and flow analysis by MRI. MRI flow analysis, clinical, and laboratory findings of each patient were retrospectively reviewed. The visible pancreaticobiliary reflux was graded on a 5-point confidence scale.


RESULTS
Among all 320 patients with pancreatic juice reflux, 14.1% had reflux scored as grades 4 and 5 combined, and 5.0% had reflux scored as grade 5. By univariate analysis and multivariate analysis, a relatively long common channel was found to be the only significant causal factor for pancreatic juice reflux. Of patients with pancreatic juice reflux of grade 4 or 5, 11.1% (5/45) also had biliary malignancies; 18.8% (3/16) of those with pancreatic juice reflux of grade 5 had biliary malignancies. Conversely, pancreatic juice reflux of grade 4 or 5 occurred in 35.7% (5/14) of patients with biliary malignancies, and reflux of grade 5 occurred in 21.4% (3/14) of those patients.


CONCLUSIONS
It was possible to evaluate pancreaticobiliary reflux using an MRI technique that may be suitable as a screening tool. Our results revealed that pancreaticobiliary reflux is relatively frequent in individuals without pancreaticobiliary maljunction.
1 Department of Radiology, Sendai City Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai, Miyagi 983-0824, Japan.
Reiji
R
Sugita
2 Department of Radiology, Ishinomaki Red Cross Hospital, Ishinomaki, Miyagi, Japan.
Akemi
A
Furuta
3 Department of Radiology, Sendai Kosei Hospital, Sendai, Miyagi, Japan.
Tetsuro
T
Yamazaki
4 Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan.
Kei
K
Ito
4 Department of Gastroenterology, Sendai City Medical Center, Sendai, Miyagi, Japan.
Yutaka
Y
Noda
D001655:Bile Reflux / Q000000981:diagnostic imaging* / Q000473:pathology; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013113:Spin Labels
D013113:Spin Labels
MRI; bile duct; bile reflux; pancreatic juice