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Published online before print October 21, 2008, 10.1148/radiol.2493080389
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(Radiology 2008;249:883-890.)
© RSNA, 2008

Gastrointestinal Imaging

Possible Biliary Disease: Diagnostic Performance of High-Spatial-Resolution Isotropic 3D T2-weighted MRCP1

Kiran R. Nandalur, MD, Hero K. Hussain, MD, William J. Weadock, MD, Erik J. Wamsteker, MD, Timothy D. Johnson, PhD, Asra S. Khan, MD, Anthony R. D'Amico, MD, Matthew K. Ford, MD, Sirisha R. Nandalur, MD, and Thomas L. Chenevert, PhD

1 From the Departments of Radiology/MRI (K.R.N., H.K.H., W.J.W., A.S.K., A.R.D., M.K.F., T.L.C.), Gastroenterology (E.J.W.), and Biostatistics (T.D.J.), University of Michigan Health System, 1500 E Medical Center Dr, MRI UHB2A209, Ann Arbor, MI 48109-0030; and Department of Radiology, William Beaumont Hospital, Royal Oak, Mich (K.R.N., S.R.N.). Received March 7, 2008; revision requested April 30; revision received May 22; final version accepted June 20. Address correspondence to H.K.H. (e-mail: hhussain{at}med.umich.edu).

Purpose: To retrospectively assess the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) performed by using a high-spatial-resolution isotropic three-dimensional (3D) fast-recovery fast spin-echo (FSE) sequence with parallel imaging for the evaluation of possible biliary disease.

Materials and Methods: This HIPAA-compliant study was approved by the institutional review board; informed consent was waived. Ninety-five patients (58 female, 37 male; mean age, 51 years; range, 15–91 years) underwent MRCP by using the respiratory-triggered isotropic 3D fast-recovery FSE sequence and endoscopic or percutaneous direct visualization between March 2003 and June 2007. Two independent readers evaluated the MRCP images for strictures, dilatation, and intraductal filling defects. Sensitivity, specificity, and interobserver agreement ({kappa} statistics) were determined.

Results: The respective sensitivity and specificity for strictures, dilatation, and intraductal filling defects (all choledocholithiasis) were 86% (40 of 47) and 94% (45 of 48), 98% (57 of 58) and 100% (37 of 37), and 68% (19 of 28) and 97% (65 of 67) for reader 1 and 88% (41 of 47) and 94% (45 of 48), 96% (56 of 58) and 100% (37 of 37), and 75% (21 of 28) and 99% (66 of 67) for reader 2. The sensitivity for stones larger than 3 mm was 94% (15 of 16) for reader 1 and 100% (16 of 16) for reader 2, whereas the sensitivity for stones 3 mm or smaller was 33% (four of 12) for reader 1 and 42% (five of 12) for reader 2. Agreement between readers was good to excellent, with {kappa} values of 0.76, 0.85, and 0.98 for strictures, dilatation, and choledocholithiasis, respectively.

Conclusion: MRCP by using the respiratory-triggered isotropic 3D fast-recovery FSE sequence with parallel imaging demonstrates excellent diagnostic capabilities for possible biliary disease, although it is limited for stones 3 mm or smaller in size.

© RSNA, 2008