Under-sampled scans with iterative reconstruction and high-frequency preserving transform (Us-IRHF) can increase the acquisition speed without degrading the image quality by recovering image information from under-sampled data. We investigate the clinical applicability of high spatial resolution magnetic resonance cholangiopancreatography (MRCP) images without extending the scanning time using Us-IRHF. A slit phantom was scanned with conventional- (without Us-IRHF), Us-IR- (without HF), and Us-IRHF scanning. The matrix size was 320 × 320 for Us-IR- and Us-IRHF- and 288 × 208 for conventional scanning. Modulation transfer function (MTF) focused on the 1.0 lp/cm gauge for each scanning was calculated. For clinical study we acquired respiratory-triggered 3D MRCP scans with and without Us-IRHF (U+-, U-MRCP) in 41 patients. The matrix size was 320 × 320 for U+- and 288 × 208 for U-MRCP. The acquisition time and the relative duct-to-periductal contrast ratios (RCs) for the right- and left intrahepatic bile-, the common bile-, and the main pancreatic duct were recorded. Visualization of each duct and overall image quality was scored on 5-point confidence scales. For visualization of each duct the score ranged from 1 (not visible) to 5 (visible with excellent details), for the image quality, it ranged from 1 (undiagnostic) to 5 (excellent). Superiority for the qualitative visualization score and non-inferiority for the RC values with prespecified margins were assessed. Phantom study showed that compared to the conventional- and Us-IR (without HF) images, the MTF for the Us-IRHF image revealed the highest response. For clinical study, the mean acquisition time was 161s for U+- and 165s for U-MRCP. For all ducts, the RC value of U+MRCP was non-inferior to U-MRCP and the qualitative visualization score assigned to U+MRCP was superior to U-MRCP. Us-IRHF improved the image quality of high spatial resolution MRCP without extending the scanning time.
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