Impact of butylscopolamine on image quality of magnetic resonance cholangiopancreatography.

To assess the effect of parenteral butylscopolamine on magnetic resonance cholangiopancreatography (MRCP) image quality. The 3D free-breathing respiratory-compensated MRCP images (mean acquisition time 7min) of 94 consecutive non-paired patients (47 with and 47 without 20mg intramuscular butylscopolamine) were analysed retrospectively. Two experienced abdominal radiologists scored the image quality of five predefined pancreaticobiliary ductal segments on the MRCP images in a blinded fashion in both cohorts using a 5 point validated scale, ranging from perfect visualization of the entire ductal structure to the ductal structure being not visible. Interobserver agreement was determined. Parenteral butylscopolamine injection significantly reduced bowel peristalsis-related artefacts of the inferior common bile duct (CBD; p=0.031) and the pancreatic duct (PD; p=0.034) for reader 1 and the inferior CBD (p=0.041) for reader 2. The difference in visualization of all remaining ductal segments, and of the overall pancreaticobiliary tree, was not statistically significant between the two cohorts. Interobserver agreement between the two readers was substantial for the superior CBD, common hepatic duct (CHD) and PD, was moderate for the inferior CBD, and was fair for the peripheral intrahepatic ducts. On free-breathing 3D MRCP images, parenteral butylscopolamine improves only the visualization of the inferior CBD and the PD. However, no significant improvement in visualization of other ductal segments was demonstrated.