Abstract
While magnetic resonance cholangiopancreatography (MRCP) is routinely used, compressed sensing MRCP (CS-MRCP) and gradient and spin-echo MRCP (GRASE-MRCP) with breath-holding (BH) may allow sufficient image quality with shorter acquisition times. This study qualitatively and quantitatively compared BH-CS-MRCP and BH-GRASE-MRCP and evaluated their clinical effectiveness. Data from 59 consecutive patients who underwent both BH-CS-MRCP and BH-GRASE-MRCP were qualitatively analyzed using a five-point Likert-type scale. The signal-to-noise ratio (SNR) of the common bile duct (CBD), contrast-to-noise ratio (CNR) of the CBD and liver, and contrast ratio between periductal tissue and the CBD were measured. Paired t-test, Wilcoxon signed-rank test, and McNemar’s test were used for statistical analysis. No significant differences were found in overall image quality or duct visualization of the CBD, right and left 1st level intrahepatic duct (IHD), cystic duct, and proximal pancreatic duct (PD). BH-CS-MRCP demonstrated higher background suppression and better visualization of right (p = 0.004) and left 2nd level IHD (p < 0.001), mid PD (p = 0.003), and distal PD (p = 0.041). Image quality degradation was less with BH-GRASE-MRCP than BH-CS-MRCP (p = 0.025). Of 24 patients with communication between a cyst and the PD, 21 (87.5%) and 15 patients (62.5%) demonstrated such communication on BH-CS-MRCP and BH-GRASE-MRCP, respectively. SNR, contrast ratio, and CNR of BH-CS-MRCP were higher than BH-GRASE-MRCP (p < 0.001). Both BH-CS-MRCP and BH-GRASE-MRCP are useful imaging methods with sufficient image quality. Each method has advantages, such as better visualization of small ducts with BH-CS-MRCP and greater time saving with BH-GRASE-MRCP. These differences allow diverse choices for visualization of the pancreaticobiliary tree in clinical practice.
Highlights
Since magnetic resonance cholangiopancreatography (MRCP) was first introduced in the 1990s, it has become an established imaging technique for noninvasive examination of the biliary tree and pancreatic duct (PD), including anatomic variations as well as various pathologies such as biliary stone disease, inflammation, and malignancy [1,2,3,4,5,6]
The score for image quality degradation by artifacts was significantly higher with BH-gradient- and spin-echo (GRASE)-MRCP than BH-compressed sensing MRCP (CS-MRCP) (4.86 ± 0.26 vs. 4.71 ± 0.42, p = 0.025)
Background suppression, visualization of right and left 2nd level intrahepatic duct (IHD), mid PD, and distal PD were significantly higher with BH-compressed sensing (CS)-MRCP than BH-GRASE-MRCP (p < 0.05, Table 2, Figure 2)
Summary
Since magnetic resonance cholangiopancreatography (MRCP) was first introduced in the 1990s, it has become an established imaging technique for noninvasive examination of the biliary tree and pancreatic duct (PD), including anatomic variations as well as various pathologies such as biliary stone disease, inflammation, and malignancy [1,2,3,4,5,6]. Alternative methods have been suggested to reduce the 3D image acquisition time, such as the 3D gradient- and spin-echo (GRASE) technique [12], 3D balanced steady-state free-precession (b-SSFP) [13], fast 3D T2-weighted turbo spin-echo (TSE) [14], or fast recovery fast spinecho (FRFSE) [15] sequences. A recent study comparing BH-CS-MRCP and BH-GRASE-MRCP was limited in that it used the same MR machine without quantitative analysis [22]. The purpose of this study was to compare BH-CS-MRCP and BH-GRASE-MRCP acquired from different MR vendors with an emphasis on both qualitative and quantitative analysis. Noticeable background signal that is distracting in image interpretation Minimal background signal without problems in observation of pancreaticobiliary tree
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