Pediatric MR cholangiopancreatography: comparison of 3D fast spin-echo and single-shot fast spin-echo thick-slab techniques for pancreaticobiliary anatomy.

Abstract

Background/aim: This study compared thick-slab and three-dimensional (3D) T2-weighted magnetic resonance cholangiopancreatography (MRCP) sequences in pediatric patients with respect to image quality and visualization of the pancreaticobiliary anatomy.

Materials and methods: The MRCP examinations of 62 pediatric patients evaluated for suspected pancreaticobiliary pathology were retrospectively reviewed, comprising a total of 69 studies. Thick-slab single-shot fast spin-echo and 3D fast spin-echo MRCP sequences were compared. The visualization of pancreaticobiliary structures was assessed using a qualitative visual scoring system. Image quality was graded as good, moderate, poor, or nondiagnostic. Biliary anatomical variations were also evaluated. Statistical analysis was performed using appropriate nonparametric tests with a significance threshold of p < 0.05.

Results: The most common clinical indication for MRCP was screening for primary sclerosing cholangitis. Overall image quality did not differ significantly between thick-slab and 3D MRCP sequences. However, 3D MRCP demonstrated significantly superior visualization of the right and left proximal bile ducts, the cystic duct, and the pancreatic duct in the pancreatic tail compared to thick-slab sequences. Biliary anatomical variations were identified in 29% of patients, with type 3a being the most frequent variation.

Conclusion: Compared to thick-slab MRCP, 3D MRCP provides improved visualization of the pancreaticobiliary anatomy in children. Optimized 3D MRCP protocols may enhance diagnostic confidence in pediatric pancreaticobiliary imaging.