The Normal Common Bile Duct And Pancreatic Duct In Both Normal And Acute Pancreatitis: A MRI Study

Objectives: To measure the diameter of the common bile duct (CBD) bymagnetic resonance imaging(MRI) in asymptomatic population and toanalyze the diameter with respect to patient age and sex and other clinicalinformation. And then establish a reference range for CBD diameter.Materials and methods: MRI of CBD was obtained in743populationsincluding203volunteers. All the743populations are free of hepatic,pancreatic and related diseases. The largest diameter of the CBD wasmeasured on MRCP. The subjects’ age, sex, the diameter of portal veindiameter (PVD), import of the cystic duct into the position and direction werenoted. In additional, the subject height, weight, body mass index (BMI) andthe CBD diameter of end-inspiration MRCP were noted. The patients weredivided into7groups according to their age. All of the factors abovementioned were compared with the CBD diameter.Results: The mean CBD diameter is (4.12±1.77) mm, with a range from1.98to7.08mm. An upper limit of5and6mm appears reasonable before andafter the age of60years. The CBD diameter was correlated with age (r=0.491;P<0.05). The CBD diameter increases by0.032mm per year. CBD diametersare significantly different between younger (<60years) and older (>60years)(P<0.05). The CBD diameters are not significantly related to gender,respiration, height, weight, BMI, the diameter of portal vein diameter (PVD),import of the cystic duct into the position and direction.Conclusions： The diameter of CBD shows a considerable increase with age. An upper limit of5and6mm appears reasonable before and after the ageof60. Objectives: To depict normal main pancreatic duct (MPD) on3.0Tmagnetic resonance imaging (MRI).Materials and methods:203health volunteers were recruited in thisstudy. MRI examine includes T1WI，T2WI and MRCP. The assessment of thepancreatic duct was performed on axial and coronal T2weighted imaging andSSFSE MR cholangiopancreatography (MRCP). The MPD, accessorypancreatic duct (APD) and the side branch were indentified on MRI. And thenthe diameter of MPD, APD and the length of APD were measured. Themorphology and variation of MPD were also analyzed.Results: The prevalence of MPD on MRI was99.51%,98.52%and93.10%in the head, body and tail of the pancreas, respectively. Theprevalence of the Santorini duct, the side branch, and the pancreas divisumwas34.00%,9.85%and5.91%, respectively. The MPD diameter was(2.46±0.22) mm,(2.19±0.19) mm, and (1.98±0.60) mm in the head, body, andtail of the pancreas, respectively. The pancreatic duct courses from the tail tothe head of the pancreas included descending (74.87%), sigmoid (11.33%),vertical (9.36%) and loop configurations (4.44%).Conclusion: MRI can well show the normal anatomy and variation ofpancreatic duct. Objectives: To study MRI findings of pancreatic duct in acutepancreatitis.Materials and methods:239patients with acute pancreatitis and125persons in control group were analyzed in this study. The severity of acutepancreatitis was graded using the APACHEⅡ and MRSI scoring system. Thenumber of the main pancreatic duct (MPD) segments visualized, MPDdiameter, and the pancreatic duct disruption were noted and compared withthe severity of acute pancreatitis.Results: The prevalence of the MPD segments visualized in acutepancreatitis was lower than that of control group patients (P<0.05). Thenumber of the MPD segments visualized was negatively correlated with theAPACHEⅡ scores (P<0.05) and MRSI scores (P<0.05). There were nodifferences in MPD caliber between acute pancreatitis and the control groupor among different severities of acute pancreatitis (P>0.05). The pancreaticduct disruption was7.9%in acute pancreatitis. The prevalence of pancreaticduct disruption was4.8%and15.3%in mild and severe acute panceatitisaccording APACHEⅡ scores and which was0%,5.7%and43.5%in mild,moderate and severe acute pancreatitis according MRSI. The prevalence ofpancreatic duct disruption was correlated with the severity of acute pancreatitis based on the APACHEⅡ scores (P<0.05) and MRSI (P<0.05).Conclusion: The pancreatic duct in acute pancreatitis patients is ofnormal caliber. The number of the MPD segments visualized and thepancreatic duct disruption on MRI in acute pancreatitis may be asupplementary indicator in determining the severity of acute pancreatitis.