Aplicaciones clínicas de la colangiopancreatografía por resonancia magnética

Soto, J.A.; Castrillón, G.A.

doi:10.1016/S0033-8338(07)73809-2

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La colangiopancreatografía por resonancia magnética (CPRM) es la alternativa diagnóstica más importante que ha surgido en los últimos años para la evaluación de las vías biliar y pancreática. Las ventajas de este método son: no utiliza medio de contraste ni radiación ionizante, no es invasivo y está exento de complicaciones y el tiempo de estudio es relativamente corto (aproximadamente entre 20 y 30 minutos). Tiene alta sensibilidad y especificidad para diagnosticar la dilatación biliar y para demostrar el sitio y la causa de la estenosis. Para los calculus biliares y pancreáticos su exactitud diagnóstica es similar a la de la colangiopancreatografía endoscópica retrógrada (CPRE). En variantes anatómicas biliopancreáticas ha reemplazado a la CPRE como método diagnóstico. En la CPRE fallida, la CPRM es casi la única modalidad diagnóstica para la evaluación de los conductos biliares. Otras aplicaciones son la colangitis esclerosante primaria, la estenosis post tranplante hepático y la valoración de las anastomosis bilioentéricas. Este artículo es una revisión de las aplicaciones clínicas de la CPRM en la evaluación de las enfermedades biliopancreáticas.

Palabras clave:

colangiopancreatografía por RM

coledocolitiasis

colangitis esclerosante

anastomosis bilioentéricas

variantes biliares congénitas

pancreatitis aguda

carcinoma de páncreas

Magnetic resonance cholangiopancreatography (MRCP) is the most important diagnostic alternative that has been developed in recent years for the evaluation of the biliary and pancreatic ducts. The advantages of this technique are: it does not use contrast media or ionizing radiation; it is noninvasive and complication free; and, the examination is relatively short (approximately 20 to 30 minutes). MRCP has high sensitivity and specificity for diagnosing biliary dilatation and for determining the site and cause of stenosis. Its diagnostic precision for biliary and pancreatic stones is similar to that of endoscopic retrograde cholangiopancreatography (ERCP). MRCP has replaced ERCP in biliary and pancreatic anatomic variants. In unsuccessful ERCP, MRCP is nearly the only diagnostic modality for the evaluation of the biliary tract. Other applications include primary sclerosing cholangitis, stenosis after liver transplantation, and the evaluation of bilioenteric anastomoses. This article reviews the clinical applications of MRCP in the evaluation of biliopancreatic diseases.

Key words:

MR colangiopancreatography

choledocolithiasis

sclerosing cholangitis

bilioenteric anastomoses

congenital biliary variants

acute pancreatitis

pancreatic of carcinoma

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