Singh Vishal, Neelavalli Jaladhar, Parvaze Suhail P, Gupta Mamta, Verma Radha K, Seth Avnish K, Mehta Lakshay, Gupta Rakesh Kumar
Fortis Memorial Research Institute, Gurgaon, India.
Philips Innovation Campus, Philips India Limited, Bengaluru, India.
Diagn Interv Radiol. 2022 Mar;28(2):131-137. doi: 10.5152/dir.2022.20713.
PURPOSE We aimed to evaluate the relative contribution of susceptibility weighted imaging (SWI) in the detection of common bile-duct (CBD) stones in comparison to the conventional MRI protocol containing magnetic resonance cholangiopancreatography (MRCP), balanced turbo field echo (BTFE), and T2-weighted spin-echo imaging techniques. METHODS MRI data containing MRCP, BTFE, T2-weighted imaging, and abdominal SWI were independently evaluated by 2 sets of experienced radiologists in 44 patients with confirmed CBD stones. Endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound where available, was used as the reference gold standard. Evaluation was performed for the visualization of CBD stones in each of the MRI techniques. Relative contribution of SWI was classified into one of four categories for each case: (1) no contribution to CBD stone visualization; (2) same as conventional techniques; (3) improved diagnostic confidence; and (4) critical for diagnosis. Stone size was also assessed. RESULTS Inter-rater agreement coefficient for CBD stone visualization was found to be "good" in MRCP (0.77), "very good" in SWI (0.94) and BTFE (0.84), and moderate in T2-weighted imaging (0.54). CBD stones were visualized with SWI in 86.4% and 82%, with MRCP in 70.5% and 70.5% cases, with BTFE in 73% and 61.4% cases, with T2-weighted imaging in 45.5% and 52.3% cases by reviewers 1 and 2, respectively. SWI did not contribute to CBD stone visualization in 2.3% (1/44); was the same as conventional techniques in 31.8% (14/44) cases; improved diagnostic confidence in 34.1%; and was critical for diagnosis in 20.5% cases. CONCLUSION SWI has the potential to serve as a strong adjunct to conventional MRI protocols used for CBD stone evaluation with very small scan-time penalty.
我们旨在评估与包含磁共振胰胆管造影（MRCP）、平衡式涡轮场回波（BTFE）和T2加权自旋回波成像技术的传统MRI方案相比，磁敏感加权成像（SWI）在检测胆总管（CBD）结石方面的相对贡献。方法：由两组经验丰富的放射科医生对44例确诊为CBD结石患者的包含MRCP、BTFE、T2加权成像和腹部SWI的MRI数据进行独立评估。将内镜逆行胰胆管造影以及可用的内镜超声用作参考金标准。对每种MRI技术中CBD结石的可视化情况进行评估。SWI的相对贡献针对每个病例分为四类之一：（1）对CBD结石可视化无贡献；（2）与传统技术相同；（3）提高诊断信心；（4）对诊断至关重要。还评估了结石大小。结果：发现MRCP中CBD结石可视化的评分者间一致性系数为“良好”（0.77），SWI中为“非常好”（0.94），BTFE中为“非常好”（0.84），T2加权成像中为中等（0.54）。评审员1和评审员2分别在86.4%和82%的病例中通过SWI观察到CBD结石，在70.5%和70.5%的病例中通过MRCP观察到，在73%和61.4%的病例中通过BTFE观察到，在45.5%和52.3%的病例中通过T2加权成像观察到。SWI在2.3%（1/44）的病例中对CBD结石可视化无贡献；在31.8%（14/44）的病例中与传统技术相同；在34.1%的病例中提高了诊断信心；在20.5%的病例中对诊断至关重要。结论：SWI有可能成为用于CBD结石评估的传统MRI方案的有力辅助手段，且扫描时间增加极少。
