What type of contrast is given during Magnetic Resonance Cholangiopancreatography (MRCP)?

From the Guidelines

Hepatobiliary contrast agents, such as gadoxetate disodium, are typically used during Magnetic Resonance Cholangiopancreatography (MRCP) to provide functional assessment of the biliary tree and detect bile leaks with high accuracy 1.

Key Points

• MRCP with hepatobiliary contrast agents allows for the detection and localization of bile leaks with an accuracy close to 100% 1.
• The use of contrast-enhanced MRCP (CE-MRCP) improves the accuracy of bile anatomy depiction and bile leak detection 1.
• Hepatobiliary contrast agents, such as gadoxetate disodium, are excreted via the bile and can be used to visualize the biliary tree and detect bile leaks 1.
• MRCP with hepatobiliary contrast agents is a non-invasive technique that does not use ionizing radiation and provides excellent anatomical information regarding the biliary tree anatomy proximal and distal to the level of injury 1.

Benefits of Hepatobiliary Contrast Agents

• Improved accuracy in detecting bile leaks and bile duct injuries
• Non-invasive technique that does not use ionizing radiation
• Excellent anatomical information regarding the biliary tree anatomy
• Can be used to guide directed approaches, such as ERCP, with brushing, percutaneous transhepatic biliary stenting, or reconstructive surgery 1

From the Research

Type of Contrast Used in MRCP

• No contrast material is required for a standard MRCP, as it relies on heavily T2-weighted sequences to highlight static fluids in the biliary and pancreatic ducts 2, 3.
• However, some studies have explored the use of negative oral contrast media to improve visualization of the ducts by reducing signal intensity from the gastrointestinal tract 4.
• Hepatobiliary-specific contrast agents, such as gadolinium ethoxybenzylic diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), can be used in contrast-enhanced MRCP to provide higher definition of the biliary tree and improve diagnosis of biliary complications 5.
• The use of contrast agents can be beneficial in certain cases, but it is not a standard requirement for MRCP 2, 3, 6.