Invest Radiol. 2018 Mar;53(3):150-157. doi: 10.1097/RLI.0000000000000421.
The aims of this study were to prospectively evaluate image quality, duct visibility, and diagnostic performance in duct-related pathologies of compressed-sensing (CS) accelerated 3-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) prototype protocols and compare these with those of conventional 3D MRCP protocol in patients with suspected pancreatic diseases.
The institutional review board approved this prospective study and all patients provided written informed consent. A total of 80 patients (47 men and 33 women; median age, 57 years; age range, 24-87 years) underwent 3D MRCP at 3.0 T. Three protocols were performed in each patient in random order: CS breath-hold (BH) protocol, CS navigator-triggered (NT) protocol, and conventional NT protocol. The acquisition time of each protocol was recorded. Image quality and duct visibility were independently rated in random order on a 5-point scale by 2 radiologists, who were blinded to the protocols. Receiver operating characteristic curves were generated, and area under the curve (Az value) was used to compare the diagnostic performance of each protocol in duct-related pathologies.
Acquisition time was 17 seconds for the CS-BH and 134.1 ± 33.5 seconds for the CS-NT protocol, both being significantly shorter than the conventional NT protocol (364.7 ± 78.4 seconds; both P < 0.01). The CS-BH MRCP protocol showed significantly less artifacts compared with the CS-NT and conventional NT protocols (both P < 0.01). Visualization of bile ducts was comparable in all 3 protocols, whereas CS-NT and conventional NT MRCP depicted pancreatic duct better than CS-BH MRCP did (for proximal, middle, and distal segment; all P < 0.05). Compressed-sensing-NT MRCP had the highest diagnostic performance for detecting ductal anomalies, long-segment duct stenosis, abnormal branch ducts, and communication between cystic lesion and pancreatic duct (mean Az value, 0.943-0.983).
Compressed-sensing MRCP is feasible in patients with suspected pancreatic diseases. Compressed-sensing-NT MRCP demonstrated superior diagnostic accuracy for duct-related pathologies.
本研究旨在前瞻性评估压缩感知（CS）加速三维（3D）磁共振胰胆管成像（MRCP）原型方案的图像质量、胆管可视性和诊断性能，并将其与疑似胰腺疾病患者常规 3D MRCP 方案进行比较。
机构审查委员会批准了这项前瞻性研究，所有患者均提供了书面知情同意书。共 80 例患者（47 名男性和 33 名女性；中位年龄 57 岁；年龄范围 24-87 岁）在 3.0T 磁共振上进行 3D MRCP。每位患者随机进行三种方案：CS 屏气（BH）方案、CS 导航触发（NT）方案和常规 NT 方案。记录每个方案的采集时间。两位放射科医生独立对图像质量和胆管可视性进行评分，他们对方案均不知情。生成受试者工作特征曲线，并使用曲线下面积（Az 值）比较每种方案在胆管相关病变中的诊断性能。
CS-BH 方案的采集时间为 17 秒，CS-NT 方案为 134.1±33.5 秒，均显著短于常规 NT 方案（364.7±78.4 秒；均 P＜0.01）。CS-BH MRCP 方案的伪影明显少于 CS-NT 和常规 NT 方案（均 P＜0.01）。所有 3 种方案的胆管显示均相似，而 CS-NT 和常规 NT MRCP 对胰管的显示优于 CS-BH MRCP（近端、中段和远段；均 P＜0.05）。CS-NT MRCP 在检测胆管异常、长段胆管狭窄、异常分支胆管和囊性病变与胰管之间的交通方面具有最高的诊断性能（平均 Az 值，0.943-0.983）。
在疑似胰腺疾病患者中，CS-MRCP 是可行的。CS-NT MRCP 对胆管相关病变具有更高的诊断准确性。
