ThP4.6 - Diagnostic Implications of Extra-biliary Revelations in Magnetic Resonance Cholangiopancreatography (MRCP) Imaging: Expanding Clinical Insights

Abstract

Abstract Aim Magnetic Resonance Cholangiopancreatography (MRCP) is increasingly utilised to assess the biliary tree. The primary aim of this study was to assess the prevalence of extra-biliary findings on MRCPs. Secondary aim was to assess the need for subsequent investigations and subsequent outcomes. Methods This was a retrospective cohort study of consecutive MRCPs performed on adult patients in a single centre from November 2020 to September 2022. Patient demographics, indication(s) for MRCP, MRCP results including extra-biliary findings and subsequent investigations and outcomes were analysed from electronic case notes. Results 1,016 MRCPs were included in this study; 616 (60.6%) were for female patients and median age was 64 years (IQR 50-75). 652 (64.2%) were inpatient and 418 (41.1%) were urgent. 592 (58.3%) had at least one extra-biliary finding and 96 (9.5%) required urgent follow-up investigations with 26 (2.6%) new diagnoses of malignancy. 213 (21%) had renal cysts, 18 (11.6%) had hepatic cysts, 69 (6.8%) had pancreatic cysts, 28 (2.8%) had liver cirrhosis, 23 (2.3%) had peripancreatic collection(s), 42 (4.1%) had a hiatus hernia, 79 (7.8%) had pleural effusion(s), 46 (4.5%) had splenomegaly and 2.6% (n=26) had identified diverticular disease. Conclusions More than half of the MRCPs conducted revealed at least one extra-biliary finding. Within the findings that required urgent investigations, more than 25% had newly diagnosed malignancy. This emphasises the high sensitivity of MRCPs extends beyond biliary pathologies and can be used in diagnosing extra-biliary pathology. We suggest a structured proforma should be used by clinical radiologists for reporting MRCPs.