Can MR Cholangiopancreatography Be Used Reliably in Children?

In a recent study reported in Pediatric Radiology, the safety and results of MR cholangiopancreatography (MRCP) on pediatric patients were examined, including the effects of secretin and a negative oral contrast agent. Additionally, the findings on MRCP were compared with those of endoscopic retrograde CP (ERCP) in patients who underwent both studies.

The Study

Over a 3-year period, any patient age 18 years younger who underwent an MRCP at the author’s institution were identified in this retrospective study.

The most frequent clinical indications for MRCP were pancreatitis and elevated liver function tests. They found that secretin allowed better delineation of the pancreatic duct as well as qualitative evaluation of the exocrine function of the pancreas. The MRCP and ERCP diagnoses were concordant in 13 of 16 patients evaluated as abnormal on MRCP.

As they discussed, MRCP is technically feasible and safe in children, and the use of both secretin enhancement and a negative oral contrast agent appears to improve both image quality and the diagnostic confidence of the radiologist.

MRCP gives additional information, compared to ERCP alone, on a variety of pathologies in the pancreaticobiliary systems. This comprehensive article summarizes the main usages of MRCP in general, and particularly in children. Besides addressing the feasibility and safety, the article comments on the use of secreting and negative oral contrast as useful adjuncts in those patients who are amenable.

Author: Basil Hubbi, MD

Reference:

Delaney L, Applegate KE,et al. MR Cholangiopancreatography in Children: Feasibility, Safety, and Initial Experience. Pediatr Radiol 2007;38 (December):64-75.