No abstract available.
Afferent Loop Syndrome* ; Cholangiopancreatography, Magnetic Resonance*

Magnetic resonance imaging (MRI) plays an important role in abdominal imaging. The high contrast resolution offered by MRI provides better lesion detection and its capacity to provide multiparametric images facilitates lesion characterization more effectively than computed tomography. However, the relatively long acquisition time of MRI often detrimentally affects the image quality and limits its accessibility. Recent developments have addressed these drawbacks. Specifically, multiphasic acquisition of contrast-enhanced MRI, free-breathing dynamic MRI using compressed sensing technique, simultaneous multi-slice acquisition for diffusion-weighted imaging, and breath-hold three-dimensional magnetic resonance cholangiopancreatography are recent notable advances in this field. This review explores the aforementioned state-of-the-art techniques by focusing on their clinical applications and potential benefits, as well as their likely future direction.
Cholangiopancreatography, Magnetic Resonance ; Hand Strength ; Magnetic Resonance Imaging

PURPOSE: We wanted to evaluate the detectability of gallstones on magnetic resonance cholangiopancreatography (MRCP) and to compare the accuracy between the single-shot turbo spin-echo (SSTSE) sequence and the three-dimensional turbo spin-echo (3DTSE) sequence with the sensitivity encoding (SENSE) technique. MATERIALS AND METHODS: A total of 141 patients who had undergone MRCP for a year period since August, 2003 were involved in the study. The source axial-SSTSE, coronal-SSTSE, source coronal-3D TSE and maximum intensity projection (MIP)-3DTSE images were obtained. Based on the operative findings and the findings of the ultrasound and CT examinations, the results of the reading by two investigators for the presence of gallstones were compared and analyzed. RESULTS: Among 141 patients, 135 patients were included in the study. 69 cases (51%) were found to have gallstones. In terms of detection of gallstones, the accuracy was 85%. The reading by one investigator greatly accorded with that of the other investigator (κ=0.94). As a result of comparing the four kinds of images obtained with the different techniques, it was found that gallstones were seen best on the source axial-SSTSE and source coronal-3DTSE images; the coronal-SSTSE image was the next best image and the MIP-3DTSE image followed (p<0.01). CONCLUSION: The detectability of gallstones on MRCP was relatively excellent and the source axial-SSTSE and source coronal-3DTSE imagings should be included for the detection of gallstones.
Cholangiopancreatography, Magnetic Resonance ; Gallbladder ; Gallstones* ; Humans ; Research Personnel ; Ultrasonography

Endoscopic retrograde cholangiopancreatography (ERCP) is a key endoscopy skill used to diagnose and treat pancreatobiliary diseases. However, its diagnostic use is decreasing in favor of other less invasive methods such as magnetic resonance cholangiopancreatography and endoscopic ultrasound. Alternatively, its use has become more important in the therapeutic area. ERCP trainees must know the anatomy and physiology of the pancreatobiliary system, several key basic skills, and complications of a successful procedure. This article briefly introduces basic ERCP knowledge, techniques, numbers necessary to achieve competency, and complications for new ERCP operators.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangiopancreatography, Magnetic Resonance ; Endoscopy* ; Pancreas ; Physiology ; Ultrasonography

Choledochal cysts are rare congenital anomalies which are principally diagnosed by disproportional dilatation of the extrahepatic bile ducts. In addition, choledochal cysts are believed to arise from the anomalous union of the common bile duct and pancreatic duct outside the duodenal wall which is also proximal to the sphincter of the Oddi mechanism. The various types of choledochal cysts have been classified on the basis of these anomalous unions (Komi classification) and their anatomical locations (Todani classification). The multidetector computed tomography with reformatted imaging, magnetic resonance cholangiopancreatography, and an endoscopic retrograde cholangiography represent the important techniques providing the anatomical resolution and detail required to properly diagnose and classify choledochal cysts and their associated abnormal features of the biliary tree, as well as their pancreaticobile duct union. This study describes the various imaging features of a choledochal cyst in adults according to the various types of anomalous unions of the pancreaticobile duct according to Komi's classification and anatomic location according to Todani's classification. Lastly, we also review and discuss the associated abnormal findings developed in biliary systems.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/classification/*diagnosis ; Humans ; Pancreatic Ducts/abnormalities

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an essential endoscopic technique in diagnosis and treatment of pancreatobiliary diseases. Although its diagnostic role is decreasing because of less invasive modalities such as magnetic resonance cholangiopancreatography or endoscopic ultrasound, it is still very important in treatment of pancreatobiliary diseases. However, there is a trend of hesitation to learn ERCP by the fellows in Korea because of following reasons; concentration of ERCP in a few high volume centers, high risk of post-procedural complications, and long training courses. In this background, the education committee of Korean Pancreatobiliary Association has prepared for ERCP educational guidelines for fellows in Korea. This guideline should be helpful to fellows who are currently under the training.
Cholangiopancreatography, Endoscopic Retrograde* ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis ; Education ; Fellowships and Scholarships ; Korea ; Ultrasonography

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an essential endoscopic technique in diagnosis and treatment of pancreatobiliary diseases. Although its diagnostic role is decreasing because of less invasive modalities such as magnetic resonance cholangiopancreatography or endoscopic ultrasound, it is still very important in treatment of pancreatobiliary diseases. However, there is a trend of hesitation to learn ERCP by the fellows in Korea because of following reasons; concentration of ERCP in a few high volume centers, high risk of post-procedural complications, and long training courses. In this background, the education committee of Korean Pancreatobiliary Association has prepared for ERCP educational guidelines for fellows in Korea. This guideline should be helpful to fellows who are currently under the training.
Cholangiopancreatography, Endoscopic Retrograde* ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis ; Education ; Fellowships and Scholarships ; Korea ; Ultrasonography

Acute pancreatitis is an inflammatory disease that can extend to extra-pancreatic tissues and distant organs. Detecting the underlying cause is important because it helps provide an appropriate treatment plan and improve prognosis. An underlying cause cannot be identified after initial evaluation in 10-30% of patients with acute pancreatitis, and they are diagnosed with idiopathic acute pancreatitis. Here, we report a case of a 77-year-old woman with acute recurrent pancreatitis caused by a branch duct-type intraductal papillary mucinous neoplasm (IPMN) and an ampulla of Vater adenoma. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed only IPMN. However, endoscopic retrograde cholangiopancreatography revealed a mucosal abnormality of the ampulla of Vater. The mucosal abnormality was documented to be an ampulla of Vater adenoma with high-grade dysplasia.
Adenoma* ; Aged ; Ampulla of Vater* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Mucins ; Pancreatitis* ; Prognosis

Acute pancreatitis is an inflammatory disease that can extend to extra-pancreatic tissues and distant organs. Detecting the underlying cause is important because it helps provide an appropriate treatment plan and improve prognosis. An underlying cause cannot be identified after initial evaluation in 10-30% of patients with acute pancreatitis, and they are diagnosed with idiopathic acute pancreatitis. Here, we report a case of a 77-year-old woman with acute recurrent pancreatitis caused by a branch duct-type intraductal papillary mucinous neoplasm (IPMN) and an ampulla of Vater adenoma. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed only IPMN. However, endoscopic retrograde cholangiopancreatography revealed a mucosal abnormality of the ampulla of Vater. The mucosal abnormality was documented to be an ampulla of Vater adenoma with high-grade dysplasia.
Adenoma* ; Aged ; Ampulla of Vater* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Mucins ; Pancreatitis* ; Prognosis

Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children. Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology. Magnetic resonance cholangiopancreatography (MRCP) is a good imaging modality for evaluating pancreatitis and determining etiology without exposure to radiation. This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.
Abdomen ; Adult ; Child ; Cholangiopancreatography, Magnetic Resonance* ; Humans ; Magnetic Resonance Imaging ; Mortality ; Pancreatitis* ; Pediatrics