Pancreatic duct: MR cholangiopancreatography with a three-dimensional fast spin-echo technique.

To determine the role of three-dimensional fast spin-echo magnetic resonance (MR) cholangiopancreatography in the evaluation of the normal and abnormal pancreatic duct. A non-breath-hold MR cholangiopancreatographic technique with use of a body coil was compared with direct pancreatography performed with endoscopic retrograde cholangiopancreatography in 37 patients. MR cholangiopancreatograms of satisfactory quality were obtained in 92% of patients. Sensitivity for detection of pancreatic duct dilatation (n = 15) was 100% and 87% (observers 1 and 2, respectively). Among patients with pancreatic duct strictures (n = 8), 75% of the strictures were detected; there was a single false-positive finding. Specificity for both observers was 69% for the maximum intensity projection reconstructions and increased to 81% with review of the source images. Four of six cases of pancreas divisum (67%) and two cases of pancreatic duct stones were demonstrated. Interobserver agreement was moderate to substantial, as assessed with kappa-analysis. MR cholangiopancreatography can accurately demonstrate the normal pancreatic duct as well as various pancreatic duct abnormalities.