Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, Toronto, ON, Canada.
Magn Reson Imaging. 2020 Jul;70:64-72. doi: 10.1016/j.mri.2020.04.011. Epub 2020 Apr 19.
To assess the added value of gadoxetic-acid-enhanced T1-weighted magnetic resonance Cholangiography (T1W-MRC) including controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA)-Volumetric Interpolated Breathhold (VIBE) technique compared to T2-weighted MR Cholangiography (T2W-MRC) in depicting biliary anatomy in potential living liver donors.
Eighty-five potential donors including 34 men with a mean age of 35.6 years (range, 18-55 years) and 51 women with a mean age of 36.7 years (range, 23-57 years), were enrolled in this ethics-approved retrospective study. Image quality for depiction of bile ducts was evaluated by two readers in consensus in 3 separate reading sessions: 1) T2W-MRC alone, 2) T1W-MRC alone (including CAIPI-VIBE and generalized autocalibrating partially parallel acquisitions (GRAPPA)-VIBE techniques, and 3) combined T1W/T2W-MRC. Accuracy of T2W-MRC, T1W-MRC, and combined T1W/T2W-MRC for the identification/classification of the biliary variants was calculated using intraoperative cholangiogram (IOC) as the reference standard. Image quality and reader diagnostic confidence provided by CAIPI-VIBE technique was compared with GRAPPA-VIBE technique. Datasets were compared using the Wilcoxon signed-rank test.
Image quality for depiction of the bile ducts was significantly superior in the combined T1W/T2W-MRC group, when compared to each of T2W-MRC and T1W-MRC groups independently (P value = 0.001-0.034). The combination of CAIPI-VIBE and GRAPPA-VIBE was superior compared to each of the sequences individually. The accuracy of T2W-MRC and T1W-MRC was 93% and 91%, respectively. T1W-MRC depicted four biliary variants better than T2W-MRC. Two variants not well seen in T2W-MRC were clearly shown on T1W-MRC.
Gadoxetic-acid-enhanced T1W-MRC and conventional T2W-MRC techniques are complementary for depiction of biliary variants in potential liver donors and the combination of the two improves the results. The combination of CAIPI-VIBE and GRAPPA-VIBE techniques appear to be complementary for optimal diagnostic yield of T1W-MRC.
评估钆塞酸增强 T1 加权磁共振胆管成像（T1W-MRC）在包括平行采集的控频技术（CAIPIRINHA）容积内插屏气（VIBE）技术中的应用，与 T2 加权磁共振胆管成像（T2W-MRC）相比，在潜在活体供肝者中对胆管解剖结构的显示有何优势。
本研究为经伦理委员会批准的回顾性研究，共纳入 85 名潜在供者，其中 34 名男性，平均年龄 35.6 岁（范围：18-55 岁），51 名女性，平均年龄 36.7 岁（范围：23-57 岁）。通过 3 次独立的阅读会议，由 2 位阅片者评估胆管显示的图像质量：1）仅 T2W-MRC；2）单独 T1W-MRC（包括 CAIPI-VIBE 和广义自动校准部分并行采集（GRAPPA）-VIBE 技术）；3）T1W/T2W-MRC 联合。以术中胆管造影（IOC）为参考标准，计算 T2W-MRC、T1W-MRC 和 T1W/T2W-MRC 对胆管变异的识别/分类的准确率。比较 CAIPI-VIBE 与 GRAPPA-VIBE 技术的图像质量和阅片者诊断信心。采用 Wilcoxon 符号秩检验比较数据集。
与 T2W-MRC 组和 T1W-MRC 组相比，T1W/T2W-MRC 组的胆管显示图像质量明显更好（P 值=0.001-0.034）。CAIPI-VIBE 和 GRAPPA-VIBE 联合的效果优于单独使用每种序列。T2W-MRC 和 T1W-MRC 的准确率分别为 93%和 91%。T1W-MRC 能更好地显示 4 种胆管变异，而 T2W-MRC 不能很好地显示的 2 种变异在 T1W-MRC 上显示得很清楚。
在潜在的肝供者中，钆塞酸增强 T1W-MRC 和常规 T2W-MRC 技术均可互补性地显示胆管变异，两者联合可提高诊断结果。CAIPI-VIBE 和 GRAPPA-VIBE 技术联合可提高 T1W-MRC 的诊断效能。
