ABSTRACT

To describe the MRCP imaging features of 24 juxtapapillary diverticula (JPD) which were inci-dentally found on the MRCP studies of the patients with pancreaticobiliary symptoms, and to deter-mine whether they effect pancreatic or biliary ducts, gall bladder, and pancreas.

Archived MRCP images which were obtained by a 1-T MR unit, were re-evaluated by two radiologists. The location and size of the JPD were noted. Intrahepatic biliary ducts, common bile duct (CBD), main pancreatic duct, gallbladder, and pancreatic parenchyma were evalu-ated to reveal any associated pancreatobiliary disease. Presence of gallbladder stones or choledo-cholithiasis, dilatation of bile ducts or pancreatic duct, deviation of the CBD caused by the JPD were noted.

All of the JPD (n: 24) were located medially at the second part of the duodenum. The mean diameter of JPD was 2,25 cm. Axial T2-weighted FSE images demonstrated air-fluid levels in 95.8% (n=23/24) of the diverticula. Excluding the six patients with previous cholecystectomy, gallbladder stones were detected in 44.4% (n=8/18) of the patients. CBD was dilated in 45.8% (n=11/24), in-trahepatic biliary ducts were dilated in 58.3% (n=14/24), and pancreatic duct was dilated in 45.8% (n=11/24) of the patients. CBD deviation was observed in 12,5% (n=3/24) of the patients. Three pa-tients (12,5%, n=3/24) had choledocholitiasis.

MRCP is a useful radiological method in determining the JPD, as well as their effects on the pancreatobiliary system. Even though this is study with a small number of patients, we can still postulate that the JPD can cause changes leading to pancreaticobiliary symptoms.

Keywords: Cholangiopancreatography, Magnetic Resonance, duodenum; diverticulum; juxta-papillary diverticulum; pancreaticobiliary symptoms