Single-Breath-Hold MRI-SPACE Cholangiopancreatography with Compressed Sensing versus Conventional Respiratory-Triggered MRI-SPACE Cholangiopancreatography at 3Tesla: Comparison of Image Quality and Diagnostic Confidence.

Olivier Chevallier,Julie Blanc,Khalid Ambarki,Bernd Kuehn,Sophie Gehin,Elisabeth Weiland,Romaric Loffroy,Sylvain Manfredi,Hélène Escande,Kévin Guillen

doi:10.3390/diagnostics11101886

Abstract

To compare two magnetic resonance cholangiopancreatography (MRCP) sequences at 3 Tesla (3T): the conventional 3D Respiratory-Triggered SPACE sequence (RT-MRCP) and a prototype 3D Compressed-Sensing Breath-Hold SPACE sequence (CS-BH-MRCP), in terms of qualitative and quantitative image quality and radiologist’s diagnostic confidence for detecting common bile duct (CBD) lithiasis, biliary anastomosis stenosis in liver-transplant recipients, and communication of pancreatic cyst with the main pancreatic duct (MPD). Sixty-eight patients with suspicion of choledocholithiasis or biliary anastomosis stenosis after liver transplant, or branch-duct intraductal papillary mucinous neoplasm of the pancreas (BD-IPMN), were included. The relative CBD to peri-biliary tissues (PBT) contrast ratio (CR) was assessed. Overall image quality, presence of artefacts, background noise suppression and the visualization of 12 separated segments of the pancreatic and bile ducts were evaluated by two observers working independently on a five-point scale. Diagnostic confidence was scored on a 1–3 scale. The CS-BH-MRCP presented significantly better CRs (p < 0.0001), image quality (p = 0.004), background noise suppression (p = 0.011), fewer artefacts (p = 0.004) and better visualization of pancreatic and bile ducts segments with the exception of the proximal CBD (p = 0.054), cystic duct confluence (p = 0.459), the four secondary intrahepatic bile ducts, and central part of the MPD (p = 0.885) for which no significant differences were found. Overall, diagnostic confidence was significantly better with the CS-BH-MRCP sequence for both readers (p = 0.038 and p = 0.038, respectively). This study shows that the CS-BH-MRCP sequence presents overall better image quality and bile and pancreatic ducts visualization compared to the conventional RT-MRCP sequence at 3T.

Highlights

Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging method used in everyday clinical practice to assess anatomical features and abnormalities of the intrahepatic and extrahepatic bile ducts and of the pancreatic ducts [1,2,3,4,5]
The freebreathing (FB) method relies on respiratory gating has well-established diagnostic performance and spatial resolution characteristics when used to evaluate diseases of the bile ducts and pancreas [2]
Among the 54 patients referred for suspected choledocholithiasis, all presented liver function test abnormalities, 11 suffered from acute pancreatitis, and 10 suffered from acute cholecystitis

Summary

Introduction

Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive imaging method used in everyday clinical practice to assess anatomical features and abnormalities of the intrahepatic and extrahepatic bile ducts and of the pancreatic ducts [1,2,3,4,5]. The freebreathing (FB) method relies on respiratory gating has well-established diagnostic performance and spatial resolution characteristics when used to evaluate diseases of the bile ducts and pancreas [2]. This method requires quite long acquisition time. Image quality too poor to allow a diagnosis. Major artefacts severely impeding the ability to make a diagnosis. Notable background noise raising major challenges with image interpretation. Visualization of the BD Common bile duct CBD, distal CBD, proximal

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