Pancreas Divisum: Evaluation with MR Cholangiopancreatography

Purpose: To determine the usefulness of magnetic resonance (MR) cholangiopancreatography in the diagnosis of pancreas divisum.

Materials And Methods: In 310 patients, MR imaging was performed with heavily T2-weighted, two-dimensional, fast-spin-echo sequences. A body coil was used for 139 patients, and a torso multicoil and high-resolution imaging parameters were used for 171 patients. In 108 patients, correlation with endoscopic retrograde cholangiopancreatography (ERCP) was available.

Results: Two hundred sixty-eight examinations (86%) were diagnostic. Pancreas divisum was observed with MR imaging in 25 of 268 cases (9%)(interobserver agreement, 98% [kappa = .88]). Among the 171 examinations performed with a torso multicoil, 10% were nondiagnostic and the rate of detection of pancreas divisum was 12%. Pancreas divisum was depicted in six of the 108 patients who underwent ERCP, and there were no false-negative or false-positive MR imaging results in these patients.

Conclusion: MR cholangiopancreatography is an accurate tool in the diagnosis of pancreas divisum and could replace ERCP.