Sudholt P, Zaehringer C, Urigo C, Tyndall A, Bongartz G, Hohmann J
Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany.
Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Switzerland.
Rofo. 2015 Jun;187(6):467-71. doi: 10.1055/s-0034-1399271. Epub 2015 Apr 15.
The aim of the study was to evaluate whether or not MRCP using a 3D-SPACE sequence allows for better image quality and a higher level of diagnostic confidence than a conventional 3D-TSE sequence at 1.5 T regarding the diagnosis of choledocholithiasis in a routine clinical setting.
3D-SPACE and 3D-TSE sequences were performed in 42 consecutive patients with suspected choledocholithiasis undergoing MRCP. Evaluation of image quality and diagnostic confidence was done on the pancreaticobiliary tree which was subdivided into 10 segments. They were scored and statistically evaluated separately for visibility and diagnostic certainty by three radiologists with differing levels of experience on a five-point scale of 1 to 5 and -2 to 2, respectively. Student t-test was performed, and the interobserver agreement was also calculated.
Image quality for each segment was significantly better for the 3D-SPACE sequence compared to the 3D-TSE sequence (4.48 ± 0.94 vs. 3.98 ± 1.20; 5-point scale p < 0.01). Diagnostic confidence for the reporting radiologist was also significantly better for 3D-SPACE than for 3D-TSE (1.68 ± 0.56 vs. 1.46 ± 0.70; 3-point scale; p < 0.01). The interobserver agreement was high in both sequences, 0.62 - 0.83 and 0.64 - 0.82, respectively.
The optimized 3D-SPACE sequence allows for better image quality in 1.5 T MRCP examinations and leads to a higher diagnostic confidence for choledocholithiasis compared to the conventional 3D-TSE sequence.
• 3D-SPACE allows for better image quality in 1.5 T MRCP.• This leads to a higher diagnostic confidence particularly in the periampullary region.• 3D-SPACE should be considered to substitute conventional 3D-TSE sequences in clinical routine MRCP.
本研究旨在评估在1.5T场强下，对于常规临床环境中胆总管结石的诊断，使用3D-SPACE序列的磁共振胰胆管造影（MRCP）是否比传统的3D-TSE序列具有更好的图像质量和更高的诊断置信度。
对42例连续怀疑患有胆总管结石且接受MRCP检查的患者进行3D-SPACE和3D-TSE序列扫描。对胰胆管树进行图像质量和诊断置信度评估，胰胆管树被分为10个节段。由三位经验水平不同的放射科医生分别对各节段的可视性和诊断确定性进行评分，并在1至5分和 -2至2分的五点量表上进行统计评估。进行了学生t检验，并计算了观察者间的一致性。
与3D-TSE序列相比，3D-SPACE序列各节段的图像质量明显更好（4.48±0.94对3.98±1.20；五点量表，p<0.01）。报告放射科医生对3D-SPACE的诊断置信度也明显高于3D-TSE（1.68±0.56对1.46±0.70；三分量表；p<0.01）。两种序列的观察者间一致性都很高，分别为0.62 - 0.83和0.64 - 0.82。
优化后的3D-SPACE序列在1.5T MRCP检查中可提供更好的图像质量，与传统的3D-TSE序列相比，对胆总管结石的诊断置信度更高。
• 3D-SPACE在1.5T MRCP中可提供更好的图像质量。• 这导致更高的诊断置信度，尤其是在壶腹周围区域。• 在临床常规MRCP中应考虑用3D-SPACE替代传统的3D-TSE序列。
