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

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.