Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul 110-744, Republic of Korea.
Eur J Radiol. 2012 Apr;81(4):e513-8. doi: 10.1016/j.ejrad.2011.06.004. Epub 2011 Jun 22.
To assess the clinical usefulness of free-breathing 3D MRCP in non-cooperative patients compared conventional breath-hold 2D MRCP.
We performed FB navigator-triggered 3D MRCP using prospective acquisition correction and BH 2D MRCP in 48 consecutive, non-cooperative patients among 772 patients. Thirteen patients had malignant obstruction. Two radiologists independently graded the likelihood of a malignant obstruction, the overall image quality, and the visibility of ten, individual anatomic segments of both the biliary and pancreatic duct in each sequence. The area under the ROC curve and the repeated measures analyses of variance with multiple comparisons were used for the comparison. The κ statistics were used for interobserver agreement.
The diagnostic performance for detecting malignancy was significantly higher on FB MRCP (A(z)=0.962) than on either BH SS-RARE (A(z)=0.820, P<0.0185) or MS-HASTE MRCP (A(z)=0.816, P<0.0067). Interobserver agreement was excellent for FB MRCP (κ=0.889) and fair for both BH SS-RARE (κ=0.578) and MS-HASTE MRCP (κ=0.49). FB MRCP had a significantly higher technical quality than BH MRCP (P<0.001). FB MRCP was seen to have statistically better visibility of peripheral IHD, right main IHD, CHD, cystic duct, and CBD than BH MRCP (P<0.001). FB MRCP and BH SS-RARE MRCP had statistically better visibility of both the left main IHD and pancreatic duct than did BH MS-HASTE MRCP (P<0.001).
FB 3D MRCP is useful for non-cooperative patients in whom conventional BH 2D methods cannot be used successfully.
评估自由呼吸 3D MRCP 在非合作患者中的临床应用价值，并与传统屏气 2D MRCP 进行比较。
我们对 772 例患者中的 48 例非合作患者分别进行了 FB 导航触发 3D MRCP 和 BH 2D MRCP 检查。其中 13 例患者存在恶性梗阻。两位放射科医生分别对两种序列诊断恶性梗阻的可能性、总体图像质量以及胆管和胰管的 10 个解剖节段的可视性进行评分。采用 ROC 曲线下面积和重复测量方差分析进行比较，采用κ 统计量评估观察者间一致性。
FB MRCP 对恶性病变的诊断性能明显高于 BH SS-RARE（A(z)=0.820，P<0.0185）和 MS-HASTE MRCP（A(z)=0.816，P<0.0067）（A(z)=0.962）。FB MRCP 的观察者间一致性为优秀（κ=0.889），BH SS-RARE 和 MS-HASTE MRCP 的观察者间一致性均为中等（κ=0.578 和κ=0.49）。FB MRCP 的技术质量明显优于 BH MRCP（P<0.001）。FB MRCP 对周围 IHID、右主 IHID、CHD、胆囊管和 CBD 的显示明显优于 BH MRCP（P<0.001）。FB MRCP 和 BH SS-RARE MRCP 对左主 IHID 和胰管的显示明显优于 BH MS-HASTE MRCP（P<0.001）。
对于不能成功应用传统 BH 2D 方法的非合作患者，FB 3D MRCP 是一种有用的检查方法。
