The difference between ERCP and MRCP is:
1, MRCP (magnetic *** vibration cholangiopancreatography) is non-invasive, is an imaging technology; ERCP (retrograde endoscopic cholangiopancreatography) is invasive, but not only for diagnosis can also be used for the treatment of choledochal stones, such as choledochal stone extraction, etc.;
2, ?ERCP is a kind of interventional ERCP is an intervention, that is to say, retrograde imaging of the bile duct through the nose; and MRCP belongs to a magnetic **** vibration examination, is the biliary tract water imaging;
3, ERCP is a kind of invasive examination, similar to do a gastroscopy, the catheter into the choledochal tube and then hit the contrast agent, take a picture; MRCP is a kind of non-invasive examination, to do the magnetic, similar to do the ct, like taking a chest X-ray. Both can examine the common bile duct. The former can also be treated at the same time as the test is done.
Expanded information:
. p>I. ERCP
Transendoscopic retrograde cholangiopancreatography (ERCP) is a technique in which a duodenoscope is inserted into the descending portion of the duodenum to locate the duodenal papilla, a contrast catheter is inserted from within the biopsy tubing to the opening of the papilla, and x-rays are taken after injection of contrast to show the pancreaticobiliary duct.
Because ERCP does not require an incision, is less traumatic, has a shorter operative time, has fewer complications than surgical procedures, and has a much shorter hospital stay, it is very popular with patients. In just a few decades ERCP has made great clinical achievements and has become an important treatment for pancreaticobiliary diseases today.
Operating procedure:
1. Insertion: The patient usually takes a prone position or left lateral position, duodenoscope through the mouth through the esophagus, stomach, into the duodenum descending, find the duodenal papilla.
2. Intubation: Selective intubation is the basis for successful ERCP diagnosis and treatment. The catheter is inserted through the biopsy hole, and the angled knob and forceps lifter are adjusted so that the catheter is perpendicular to the opening of the papilla, and the catheter is inserted into the papilla. Most ERCP physicians should have a success rate of intubation greater than 85 % or more, and selective intubation under guidewire guidance has a high success rate and fewer complications.
3. Imaging: Contrast agent is injected through the catheter under fluoroscopy, and the bile duct or pancreatic duct is visualized on the fluoroscope to show the lesion. Minimize unnecessary pancreatic duct visualization to prevent postoperative pancreatitis.
4. Film: After the pancreaticobiliary duct is visualized, film storage is performed.
5. Treatment: According to the patient's pancreaticobiliary pathology, different endoscopic treatment measures (e.g. sphincterotomy for stone removal, placement of drain or stent to relieve bile duct obstruction, fistula stent placement, etc.) are taken.
II. MRCP
Magnetic Resonance Cholangiopancreatography (MRCP) is a technique that utilizes a sequence of heavy T2-weighted pulses to display tissue structures with very long T2 relaxation times.
Magnetic resonance cholangiopancreatography (MRCP) is a technique that uses a sequence of heavy T2-weighted pulses to visualize tissue structures with very long T2 relaxation times. Substantial organs such as the liver, spleen, and pancreas have short T2 relaxation times and appear as low signal on heavy T2-weighted sequences. Adipose tissue has a moderately long T2 relaxation time, and the fat signal can be suppressed by applying various fat suppression techniques such as frequency selection or inversion suppression.
Fast-flowing fluids, such as blood flow in the portal vein or hepatic vein, show signal loss on the image due to the flow-void phenomenon, and only resting or relatively resting fluids show high signal. The bile in the biliary system is a relatively stationary fluid, so MRCP can clearly show the morphologic structure of the biliary system.
Single-level, thick-layer acquisition, which is characterized by no post-processing, obtains an MRCP projection image of the entire volume of the biliary system in only 1 layer, similar to X-ray cholangiopancreatography. The technique utilizes SSFSE with a long TR time (also known as the single excitation RARE technique), and the scan time is extremely short.
Using a GE 0.2T, Signa Profile permanent magnet type magnetic **** vibration imager with a torso flexible coil, without respiratory gating, the patient fasted for 8-12h before the examination, and breath-holding training was performed before the positioning (inhalation-exhalation-breath-holding). Transverse T2WI scanning was performed first, and then radial localization scanning was done centered on the dilated bile ducts shown in the transverse image.
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