An Observational Study on Evaluation of Intrahepatic Biliary Tree Anatomy and Its Variation by Magnetic Resonance Cholangiopancreatography

Abstract Introduction: The biliary tree's complex anatomy with its intrahepatic and extrahepatic components presents numerous variations, necessitating a thorough understanding for successful hepatobiliary surgeries. Magnetic Resonance Cholangiopancreatography (MRCP) has emerged as a crucial non-invasive imaging technique for assessing pancreaticobiliary disorders, offering detailed anatomical visualization. Objectives: This study aimed to estimate the prevalence of various biliary tree variations and classify intrahepatic biliary tree variations according to Huang and Cho classifications based on MRCP. Methodology: An observational, hospital-based cross-sectional study was conducted in the Department of Radiodiagnosis, SMS Medical College and Hospital, Jaipur, Rajasthan. Seventy patients undergoing MRCP were included in the study, and data were collected using a pre-designed, pre-validated, and pre-tested proforma. MRCP was performed using a 3T Philips Ingenia MRI Machine, and images were acquired with thin sections or with multiple thick slabs to visualize the biliary tree. Results: The study population consisted of 35 males and 35 females, with a mean age of 50.5 ± 13.2 years. Cholelithiasis was the most common lesion identified, followed by GB Malignancy, Choledocholithiasis, and Chronic pancreatitis. Gender distribution showed a male predominance in certain conditions. The majority of patients had Huang Classification type A1 variations. Cho Classification showed a higher prevalence of type 1 variations. No significant association was found between gender and biliary tree anatomy diagnoses. Conclusion: MRCP, particularly with the use of advanced techniques such as the Thick Slab Single Shot Spin Echo Turbo Echo Sequence and Three-Dimensional Turbo Spin Echo sequence, plays a crucial role in evaluating biliary anatomy and variations. This information is essential for preoperative planning in hepatobiliary surgeries, aiding in the prevention of complications.