Definition of age-dependent reference values for the diameter of the common bile duct and pancreatic duct on MRCP: A population-based, cross-sectional cohort study

Research output: Contribution to journalResearch articleContributedpeer-review


  • Georg Beyer - , Ludwig Maximilian University of Munich (Author)
  • Florian Kasprowicz - , Ludwig Maximilian University of Munich, University of Greifswald (Author)
  • Anke Hannemann - , University of Greifswald, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)
  • Ali Aghdassi - , University of Greifswald (Author)
  • Patrick Thamm - , University of Greifswald (Author)
  • Henry Volzke - , Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), University of Greifswald (Author)
  • Markus M. Lerch - , University of Greifswald, Ludwig Maximilian University of Munich (Author)
  • Jens Peter Kühn - , Institute and Polyclinic of Diagnostic and Interventional Radiology, University of Greifswald (Author)
  • Julia Mayerle - , Ludwig Maximilian University of Munich, University of Greifswald (Author)


Objective Changes of the pancreaticobiliary ducts herald disease. Magnetic resonance cholangiopancreatography (MRCP) allows accurate duct visualisation. Data on reliable upper reference ranges are missing. Design Cross-sectional whole body MRI data from the population-based Study of Health in Pomerania were analysed. The width of the common bile duct (CBD) and the pancreatic duct (PD) was determined. We aimed to describe the distribution of physiological duct diameters on MRCP in a population of healthy subjects and to identify factors influencing duct size. Results After excluding pre-existing pancreaticobiliary conditions, CBD and PD diameters from 938 and 774 healthy individuals, respectively, showed a significant increase with age (p<0.0001) and exceeded the conventional upper reference limit of normal in 10.9% and 18.2%, respectively. Age-dependent upper reference limits of duct diameters were delineated with non-parametric quantile regression, defined as 95th percentile: for CBD up to 8 mm in subjects <65 years and up to 11 mm in subjects ≥65 years. For the PD reference diameters were up to 3 mm in subjects <65 years and up to 4 mm in subjects ≥65 years. Conclusions This is the first population-based study delineating age-adjusted upper reference limits of CBD and PD on MRCP. We showed that up to 18.2% of healthy volunteers would have needed diagnostic workup, if the conventional reference values were used. The utilisation of the adapted reference levels may help to avoid unnecessary investigations and thus to reduce healthcare expenditure and test-related adverse events.


Original languageEnglish
Pages (from-to)1738-1744
Number of pages7
Issue number9
Publication statusPublished - 1 Sept 2023

External IDs

PubMed 36828626


Sustainable Development Goals

ASJC Scopus subject areas


  • Magnetic Resonance Imaging, cholangiocarcinoma, diagnostic and therapeutic endoscopy, epidemiology, pancreatic cancer, Cross-Sectional Studies, Humans, Reference Values, Pancreatic Ducts/diagnostic imaging, Common Bile Duct/pathology, Aged, Cholangiopancreatography, Magnetic Resonance, Cohort Studies