Abstract
BackgroundMagnetic resonance cholangiopancreatography (MRCP) is an established technique for the evaluation of intra- and extrahepatic bile ducts in patients with known or suspected hepatobiliary disease. However, the ideal acquisition and reconstruction plane for optimal bile duct evaluation with 3D technique has not been evaluated. The purpose of our study was to compare different acquisition and reconstruction planes of 3D-MRCP for bile duct assessment.Methods34 patients (17f/17 m, mean age 41y) referred for MRCP were included in this prospective IRB-approved study. Respiratory-triggered 3D-T2w-MRCP sequences were acquired in coronal and axial plane. Coronal and axial MIP were reconstructed based on each dataset (resulting in two coronal and two axial MIP, respectively). Three readers in two sessions independently assessed the MIP, regarding visualization of bile ducts and image quality. Results were compared (Wilcoxon test). Intra- and interobserver variability were calculated (kappa-statistic).ResultsIn case of coronal data acquisition, visualization of bile duct segments was significantly better on coronal reconstructed MIP images as compared to axial reconstructed MIP (p < 0.05). Regarding visualization, coronal MIP of the coronal acquisition were equal to coronal MIP of the axial acquisition (p > 0.05). Image quality of coronal and axial datasets did not differ significantly. Intra- and interobserver agreement regarding bile duct visualization were moderate to excellent (κ-range 0.55-1.00 and 0.42-0.85, respectively).ConclusionsThe results of our study suggest that for visualization and evaluation of intra- and extrahepatic bile duct segments reconstructed images in coronal orientation are preferable. The orientation of the primary dataset (coronal or axial) is negligible.
Highlights
Magnetic resonance cholangiopancreatography (MRCP) is an established technique for the evaluation of intra- and extrahepatic bile ducts in patients with known or suspected hepatobiliary disease
Most current MRCP techniques are based on heavily T2-weighted fast spin echo (FSE) pulse sequences, which
To the best of our knowledge, the ideal acquisition and reconstruction plane, in practical terms meaning best suitable for optimal bile duct visualization with 3D techniques, has not been evaluated
Summary
Magnetic resonance cholangiopancreatography (MRCP) is an established technique for the evaluation of intra- and extrahepatic bile ducts in patients with known or suspected hepatobiliary disease [1]. It is considered a reliable non-invasive alternative to diagnostic endoscopic retrograde cholangiopancreatography (ERCP) [2,3]. The purpose of this study was to compare different acquisition and reconstruction planes of T2-weighted 3D-MRCP acquisitions for assessment of the intra- and extrahepatic bile ducts
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