Jang Weon, Song Ji Soo, Kim Sang Heon, Yang Jae Do
Department of Radiology, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea.
Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Korea.
Diagnostics (Basel). 2021 Apr 1;11(4):634. doi: 10.3390/diagnostics11040634.
While magnetic resonance cholangiopancreatography (MRCP) is routinely used, compressed sensing MRCP (CS-MRCP) and gradient and spin-echo MRCP (GRASE-MRCP) with breath-holding (BH) may allow sufficient image quality with shorter acquisition times. This study qualitatively and quantitatively compared BH-CS-MRCP and BH-GRASE-MRCP and evaluated their clinical effectiveness. Data from 59 consecutive patients who underwent both BH-CS-MRCP and BH-GRASE-MRCP were qualitatively analyzed using a five-point Likert-type scale. The signal-to-noise ratio (SNR) of the common bile duct (CBD), contrast-to-noise ratio (CNR) of the CBD and liver, and contrast ratio between periductal tissue and the CBD were measured. Paired t-test, Wilcoxon signed-rank test, and McNemar's test were used for statistical analysis. No significant differences were found in overall image quality or duct visualization of the CBD, right and left 1st level intrahepatic duct (IHD), cystic duct, and proximal pancreatic duct (PD). BH-CS-MRCP demonstrated higher background suppression and better visualization of right ( = 0.004) and left 2nd level IHD ( < 0.001), mid PD ( = 0.003), and distal PD ( = 0.041). Image quality degradation was less with BH-GRASE-MRCP than BH-CS-MRCP ( = 0.025). Of 24 patients with communication between a cyst and the PD, 21 (87.5%) and 15 patients (62.5%) demonstrated such communication on BH-CS-MRCP and BH-GRASE-MRCP, respectively. SNR, contrast ratio, and CNR of BH-CS-MRCP were higher than BH-GRASE-MRCP ( < 0.001). Both BH-CS-MRCP and BH-GRASE-MRCP are useful imaging methods with sufficient image quality. Each method has advantages, such as better visualization of small ducts with BH-CS-MRCP and greater time saving with BH-GRASE-MRCP. These differences allow diverse choices for visualization of the pancreaticobiliary tree in clinical practice.
虽然磁共振胰胆管造影(MRCP)是常规使用的方法,但屏气(BH)的压缩感知MRCP(CS-MRCP)和梯度与自旋回波MRCP(GRASE-MRCP)可能在更短的采集时间内提供足够的图像质量。本研究对BH-CS-MRCP和BH-GRASE-MRCP进行了定性和定量比较,并评估了它们的临床有效性。对连续59例接受BH-CS-MRCP和BH-GRASE-MRCP检查的患者的数据,使用五点李克特量表进行定性分析。测量胆总管(CBD)的信噪比(SNR)、CBD与肝脏的对比噪声比(CNR)以及导管周围组织与CBD之间的对比率。采用配对t检验、Wilcoxon符号秩检验和McNemar检验进行统计分析。在整体图像质量或CBD、左右一级肝内胆管(IHD)、胆囊管和近端胰管(PD)的导管可视化方面未发现显著差异。BH-CS-MRCP在背景抑制方面表现更好,对右侧(P = 0.004)和左侧二级IHD(P < 0.001)、胰管中部(P = 0.003)和胰管远端(P = 0.041)的可视化效果更佳。BH-GRASE-MRCP导致的图像质量下降比BH-CS-MRCP少(P = 0.025)。在24例囊肿与胰管相通的患者中,分别有21例(87.5%)和15例(62.5%)在BH-CS-MRCP和BH-GRASE-MRCP上显示出这种相通情况。BH-CS-MRCP的SNR、对比率和CNR均高于BH-GRASE-MRCP(P < 0.001)。BH-CS-MRCP和BH-GRASE-MRCP都是具有足够图像质量的有用成像方法。每种方法都有其优点,例如BH-CS-MRCP对小导管的可视化效果更好,而BH-GRASE-MRCP节省时间更多。这些差异为临床实践中胰胆管树的可视化提供了多样的选择。