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Magnetic Resonance Cholangiopancreatography (MRCP)

Last updated Feb. 6, 2019

Approved by: Maulik P. Purohit MD MPH

Hellerhoff

Magnetic resonance cholangiopancreatography of a pancreatic divisum: (a) gall bladder, (b) bile duct crossing the (c) long duct of Santorini, (d) a short pancreatic duct together with the bile duct on the major duodenal papilla, (e) imaged with renal collecting system.


Background Information:

What are the other Names for the Procedure?

  • Magnetic Resonance Imaging of Hepatobiliary and Pancreatic Systems
  • MRCP (Magnetic Resonance Cholangiopancreatography)
  • MRI of Hepatobiliary and Pancreatic Systems

What is Magnetic Resonance Cholangiopancreatography radiology procedure? (General Explanation)

  • Magnetic resonance imaging (MRI) is a noninvasive medical test that uses a powerful magnetic field to produce images of soft tissues, bones, organs, and all other internal body structures. An MRI does not use any radiation for visualizing the body parts
  • A Magnetic Resonance Cholangiopancreatography (MRCP) is a special MRI exam of the hepatobiliary and pancreatic systems
  • It provides detailed images of the liver, gallbladder, bile ducts, pancreas, and pancreatic ducts and helps treat medical conditions associated with these organs and systems

What part of the Body does the Procedure involve?

The upper and mid abdominal region is involved in the Magnetic Resonance Cholangiopancreatography procedure.

Why is the Magnetic Resonance Cholangiopancreatography radiology procedure Performed?

The Magnetic Resonance Cholangiopancreatography procedure is used to diagnose various medical conditions and examine organs systems as follows:

  • To diagnose the cause of pancreatitis
  • To detect the cause of abdominal pain
  • To evaluate the gallbladder, liver, bile ducts, pancreas, and pancreatic ducts
  • To diagnose tumors, infections, or inflammations associated with hepatobiliary and pancreatic systems

What is the Equipment used? (Description of Equipment)

The equipment used for Magnetic Resonance Cholangiopancreatography is the following:

  • An MRI is a large cylinder-shaped tube that is surrounded by a circular magnet
  • The patient lies on the table that slides back and forth in the cylinder tube
  • In some MRI equipment, called short-bore systems, the magnet does not completely surround the patient. This is particularly helpful for patients who are obese, or those fearful of being in a closed tube. This is called an open MRI

What are the Recent Advances in the Procedure?

There have been no recent advances to the MRCP procedure.

What is the Cost of performing the Magnetic Resonance Cholangiopancreatography radiology procedure?

The cost of Magnetic Resonance Cholangiopancreatography (MRCP) procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary. 

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Magnetic Resonance Cholangiopancreatography procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.ncbi.nlm.nih.gov/pubmed/25472755 (accessed on 07/20/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25518792 (accessed on 07/20/2015)

http://www.ncbi.nlm.nih.gov/pubmed/25489567 (accessed on 07/20/2015)

Prior to Magnetic Resonance Cholangiopancreatography radiology procedure:

How does the Magnetic Resonance Cholangiopancreatography radiology procedure work?

  • The MRI equipment uses magnet fields instead of ionizing radiation
  • An electrical current passes through coils in order to produce a magnetic field
  • Other coils send and receive radio waves and signals that are detected by the coils
  • A computer processes the signals and generates images, showing thin slices of the body part/region

How is the Magnetic Resonance Cholangiopancreatography radiology procedure Performed?

The Magnetic Resonance Cholangiopancreatography procedure is performed as:

  • The patient is positioned on the moveable examination table
  • The respiratory gating belt is placed on the patient’s upper abdomen, to see how the patient is breathing during the imaging
  • The patient may be given a contrast material through an IV line inserted in the patient’s arm vein
  • The patient has to remain still during the procedure, in order to avoid any blurriness of the images
  • The patient is moved into the MRI unit and images are taken, while the radiologist is checking the images in another room

Where is the Procedure Performed?

A Magnetic Resonance Cholangiopancreatography exam is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A radiology technologist performs the Magnetic Resonance Cholangiopancreatography procedure under the supervision of radiologist.

How long will the Procedure take?

The Magnetic Resonance Cholangiopancreatography exam usually takes about 45-60 minutes to perform.

Who interprets the Result?

The radiologist interprets the results of the procedure and informs the primary care physician.

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Magnetic Resonance Cholangiopancreatography procedure:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the X-ray
  • Women should notify the physician, if they are pregnant or breastfeeding their child; as many such procedures may not be performed on pregnant women
  • The patient may be asked to avoid eating or drinking, several hours before the test
  • It is recommended to notify the physician about any implants or metal objects in the body, such as a pacemaker, nerve simulators, surgical staples, or artificial heart valves, braces, or dyed tattoos, as they may interfere with the imaging, in some cases
  • Those with metal objects in their body may be required to have an x-ray taken, before the MRI scan. In many cases, having a metal object in the body is a contraindication for performing an MRI scan

What is the Consent Process before the Procedure?

A physician will request your consent for the Magnetic Resonance Cholangiopancreatography procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of a Magnetic Resonance Cholangiopancreatography scan:

  • MRCP provides very detailed and clear images of the hepatobiliary and pancreatic systems compared to other imaging modalities
  • The MRI does not use any ionizing radiation
  • The contrast material used in the MRI is less likely to produce an allergic reaction, than contrast materials used in other procedures
  • It is a non-invasive technique
  • The MRI helps determine the organ structure and how functional they are
  • The MRCP procedure is less invasive than an ERCP (endoscopic retrograde cholangiopancreatography) procedure

Following are the risks of a Magnetic Resonance Cholangiopancreatography scan:

  • Generally, patients undergoing an MRI procedure have almost no risk associated with the procedure
  • The MRI uses a strong magnetic field, which can affect medically-implanted metal devices
  • The patient may experience an allergic reaction due to the contrast material used in the procedure; though it is very rare
  • There is a very rare chance of developing nephrogenic systemic fibrosis, if high doses of gadolinium contrast material are used in patients with very poor kidney function
  • There is a chance of excessive sedation, if sedation is used in the procedure

What are the Limitations of the Magnetic Resonance Cholangiopancreatography radiology procedure?

Following are the limitations of a Magnetic Resonance Cholangiopancreatography scan:

  • The MRI scan is quite expensive and takes more procedure performing time than other imaging techniques
  • The patient must remain still, in order to obtain high-quality images through the scan
  • MRI scans take longer than other procedures and require keeping life-support equipment away from the machine. Thus, it is not used in acutely injured patients and in emergency situations
  • In some cases, obese or large patients may have a difficulty in bodily-fitting into a conventional MRI machine
  • An MRI scan cannot distinguish between edema caused by infection, inflammation, or cancer
  • Pregnant women are usually advised against having an MRI exam, unless it is deemed absolutely necessary

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is a Magnetic Resonance Cholangiopancreatography (MRCP) procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required after the procedure?
  • Is there any medication that needs to be taken for life after the procedure?
  • What are the costs involved?

During the Magnetic Resonance Cholangiopancreatography radiology procedure:

What is to be expected during the Magnetic Resonance Cholangiopancreatography radiology procedure?

The following may be expected during the Magnetic Resonance Cholangiopancreatography procedure:

  • The magnetic resonance imaging exam is a painless procedure
  • The table you lie on may feel hard and the room may be cool. However, the patient may find it uncomfortable to stay still for a long time
  • If the patient is claustrophobic (fear of being in closed spaces), sedation may be used to help the patient to relax
  • The patient may hear tapping or thumping sounds, when images are taken and may relax between the imaging sequences. If the patient wants to avoid the machine noise, they may request ear plugs
  • Some people feel nervous inside the MRI scanner, due to the noise of the equipment; this is quite normal
  • The patient is usually alone in the scan room during an MRI procedure, but the technologist will be able to see, hear, and speak, to the patient during the procedure
  • The patient may feel a little warm on the part of the body, where images are taken
  • A cooling and flushing sensation may be felt for a few minutes, when the contrast material is injected. Very rarely, the patient may feel nauseous, due to the contrast material
  • Recovery period is not necessary for patients, who are not sedated. These patients may resume their normal activities immediately after the exam

What kind of Anesthesia is given, during the Procedure?

Anesthesia is rarely used during the Magnetic Resonance Cholangiopancreatography procedure.

How much Blood will you lose, during the Procedure?

Since Magnetic Resonance Cholangiopancreatography is a minimally-invasive procedure, there is no significant blood loss involved.

What are the possible Risks and Complications during the Magnetic Resonance Cholangiopancreatography radiology procedure?

Generally, there are no risks associated with the MRI procedure. However, the following may be observed:

  • The MRI uses a strong magnetic field, which may affect any metal medically-implanted devices in the body
  • Rarely, the patient may experience an allergic reaction due to the contrast material used in the procedure

What Post-Operative Care is needed at the Healthcare Facility after the Magnetic Resonance Cholangiopancreatography radiology procedure?

No specific post-operative care is needed at the healthcare facility after the Magnetic Resonance Cholangiopancreatography procedure.

After the Magnetic Resonance Cholangiopancreatography radiology procedure:

What is to be expected after the Magnetic Resonance Cholangiopancreatography radiology procedure?

  • Patients who are sedated may take a short period of time to recover from the Magnetic Resonance Cholangiopancreatography procedure
  • Others, who have not been sedated, can resume their regular activities almost immediately

When do you need to call your Physician?

If the patient is experiencing an allergic reaction from the contrast reaction, then do contact the physician immediately.

What Post-Operative Care is needed at Home after the Magnetic Resonance Cholangiopancreatography radiology procedure?

No specific post-operative care is needed at home after the Magnetic Resonance Cholangiopancreatography procedure.

How long does it normally take to fully recover, from the Procedure?

Generally, there is no recovery period necessary for patients, who are not sedated. These patients may resume their normal activities and diet immediately after the MRCP exam.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The Magnetic Resonance Cholangiopancreatography procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Magnetic Resonance Cholangiopancreatography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Magnetic Resonance Cholangiopancreatography (MRCP) procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 26, 2015
Last updated: Feb. 6, 2019