[Passive and active magnetic resonance cholangiopancreatography : Technique, indications, and typical anatomy].

CLINICAL/METHODICAL ISSUE: In daily routine, every radiologist is confronted with a variety of questions concerning the biliary tract and pancreatic system.

STANDARD RADIOLOGICAL METHODS: Today, besides sonography, magnetic resonance cholangiopancreatography (MRCP) is considered the method of choice in the investigation of many disorders of the hepatobiliary and pancreatic system and is commonly preferred over invasive ERCP in a mere diagnostic setting.

METHODICAL INNOVATIONS: Since its introduction in 1991, MRCP has constantly evolved. Major innovations have been the reduction of acquisition time by using fast spin echo (FSE) sequences, the use of respiratory gating and contrast-enhanced imaging of the bile ducts with hepatobiliary-specific MRI contrast agents.

PERFORMANCE: Many diagnoses may already be made with noncontrast enhanced images. By supplemental administration of a hepatobiliary-specific contrast agent, it is also possible to evaluate the flow dynamics of the bile. This is of additional value especially in patients who underwent surgery of the biliodigestive system or endoscopic interventions.

ACHIEVEMENTS: Aside from robustness and reproducibility, a major advantage of this technique is the modular design of imaging protocols, which can easily be adapted to the clinical question.

PRACTICAL RECOMMENDATIONS: MRCP is a reliable and low-risk imaging method for primary diagnosis and follow-up of biliary and pancreatic pathologies.