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Gastrointestinal Imaging |
1 From the Department of Radiology (A.S., K.H.Z., S.T.), Division of Abdominal Imaging and Intervention (K.J.M., M.A.B., C.M.C.T.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; and Department of Health Care Policy, Harvard Medical School, Boston, Mass (K.H.Z.). Received December 18, 2003; revision requested February 20, 2004; revision received February 22, 2005; accepted March 17; final version accepted May 2. Address correspondence to A.S. (e-mail: asodickson{at}partners.org).
Purpose: To retrospectively evaluate the technical quality of and the visibility of the biliary tree and pancreatic duct on magnetic resonance (MR) cholangiopancreatographic (MRCP) images obtained with a single-breath-hold three-dimensional (3D) fast-recovery fast spin-echo (FRFSE) sequence in comparison with conventional two-dimensional (2D) single-shot fast spin-echo (SSFSE) thin-section and thick-slab sequences.
Materials and Methods: Institutional review board approval was obtained; informed consent was not required for this HIPAA-compliant study. MRCP was performed at 1.5 T in 53 consecutive patients (25 men and 28 women, aged 23–84 years). A single-breath-hold volume acquisition was performed by using the 3D FRFSE sequence and the conventional 2D SSFSE sequences. Two radiologists graded studies obtained with each sequence in a blinded fashion, and the paired Student t test was used to assess differences in technical quality, visibility of eight individual ductal segments of the biliary tree and pancreatic duct, and number of ductal segments visualized per patient.
Results: Studies obtained with 3D FRFSE were of significantly higher technical quality than those obtained with thin-section 2D SSFSE (P < .02 for both readers). The 3D FRFSE maximum intensity projection reconstruction and 2D SSFSE thick-slab sequence proved statistically equivalent with regard to the overall visibility of the biliary tree and pancreatic duct and the number of ductal segments visualized per patient. In comparison with 2D SSFSE thin-section imaging, however, 3D FRFSE imaging produced an improved overall duct segment visibility grade of 0.45 on a three-point visibility scale (P < .001), with a corresponding average per-patient improvement of 1.9 out of eight possible fully visualized duct segments (P < .001).
Conclusion: The 3D FRFSE sequence shows promise for improved visibility of the pancreatic duct and biliary tree, compared with the conventional 2D SSFSE thin-section and thick-slab approach, while permitting the entire MRCP examination to be performed in a single breath hold.
© RSNA, 2006
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