Combination of cross-sectional MRI, MRCP and gadolinium-enhanced dual-phase 3D-MRA in the staging of pancreatic tumors:: first clinical results.

Purpose: To evaluate the accuracy of a non-invasive "all-in-one" staging MR method in patients with pancreatic tumors. Material and Methods: 46 patients were prospectively evaluated by a combined MR imaging protocol including breath-hold T-1- and T-2-weighted pulse sequence, MRCP using a breath-hold 2D-RARE sequence, and breath-hold gadolinium-enhanced dual-phase 3D-MR angiography. Results: All pancreatic tumors were detected by the combination of cross-sectional imaging and MRCP. in spite of the use of MRCP, definitive differentiation between pancreatic carcinoma and chronic pancreatitis was not possible in 3 (6.5%) out of 46 cases. High quality 3D-MR angiograms were obtained in 43 (93.5%) cases. in 6 (13%) patients 3D-MRA showed an aberrant right hepatic artery. The overall accuracy of MRI in assessing extrapancreatic tumor spread, lymph node metastases, liver metastases, and vascular involvement was 95.7%, 80.4%, 93.5%, and 89.1%, respectively. Conclusion: Due to its high accuracy, the "all-in-one" MR protocol may became the most important modality after clinical examination and ultrasound in the diagnostic work-up for-most patients with suspicion of pancreatic tumors.