Date Created: 1.15.2020
MRCP (Magnetic Resonance Cholangio Pancreatography)
A) Preparation or initial instructions:
- Fast at least 4 hours prior to exam
- Coil: body array coil (modify based on child’s age)
- Coverage: inferior lung bases through iliac crest.
- Secretin – may improve visualization of pancreatic duct; dose - 0.2- μgm/kg IV [1]
- Negative oral contrast agent – Acai/Blueberry/Pineapple juice [2] or other commercially available agent
B) Protocol table:
|
Sequence Name
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Vendor Specific name
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Plane
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Fat suppression
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Motion compensation
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Other relevant parameters
|
Additional info
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1. T2Single Shot
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T2 HASTE, SSFSE, sSH-TSE
|
Axial, Coronal
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Yes
|
Free Breathing(FB)
|
|
|
|
2. T2 FSE radial
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BLADE, PROPELLER, MultiVane
|
Axial
|
Yes
|
RT, BH
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|
|
|
3. Balanced Steady State free precession
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True FISP, FIESTA, balanced FFE
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Axial/coronal
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Yes
|
RT, BH
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|
|
|
4. 3D MRCP
|
|
Coronal Oblique
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Yes
|
RT
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MIPs of biliary tree with rotating tumble TE 500-1000msec
|
|
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Optional Sequences
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|
|
|
|
|
|
|
5. T1 FS 3D GRE
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VIBE, LAVA, THRIVE
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Axial, Coronal
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Yes
|
Pre-post contrast BH
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Optional 1.) evaluation for focal liver lesions or 2.) Contrast enhanced MRCP in hepatobiliary phase looking for bile leaks or strictures
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See dynamic liver protocol for specific contrast agents and timig
|
|
|
|
|
|
|
|
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BH =Breath-hold; FB = Free Breathing; RT = Respiratory Triggered; sSH = single-shot; T/FSE = Turbo/Fast Spin-echo
C) References:
- Chavon GB, Babyn PS, Manson D, et al (2008) Pediatric MR Cholangiopancreatography: Principles, Techniques, and Clinical Applications
- Bittman ME, Callahan MJ (2014) The effective use of acai juice, blueberry juice, and pineapple juice as negative oral contrast agents for magnetic resonance cholangiopancreatography in children. Pediatr Radiol 44: 883-887