MR cholangiopancreatography of pancreaticobiliary diseases: comparing single-shot RARE and multislice HASTE sequences.

OBJECTIVE

In this study, we compared the single-shot rapid acquisition with relaxation enhancement (RARE) sequence with the multislice half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence to assess the ability of each technique to show various pancreaticobiliary diseases using MR cholangiopancreatography.

SUBJECTS AND METHODS

MR cholangiopancreatography was performed using both the single-shot RARE and the multislice HASTE pulse sequences in 80 consecutive subjects in whom we had proof of a range of diagnoses. The study population included healthy subjects (n = 9), patients with benign lesions (n = 41), and patients with malignant lesions (n = 30). We analyzed each image using the following criteria: the cause of the lesions, the image quality (i.e., the amount of artifact and the sharpness of anatomic structures such as the right and left hepatic ducts, the extrahepatic bile duct, and the main pancreatic duct), and the reviewers' preference of images. The images were evaluated independently by two radiologists who were unaware of the results of the other cholangiopancreatographic sequence and of the diagnosis.

RESULTS

Artifacts were less prominent in images that were obtained using the single-shot RARE sequence (p = .0192); however, the sharpness of anatomic structures was the same using either sequence (p = .1673). For images that were obtained using the single-shot RARE technique, the sensitivity, specificity, and accuracy in distinguishing malignant from other abnormalities were 83%, 78%, and 80%, respectively; for the multislice HASTE technique, these values were 77%, 72%, and 74%, respectively (p > .05). Disease-specific accuracy in determining the correct diagnosis was 54% and 59%, respectively (p > .05). In patients in whom all the ducts needed to be defined, the single-shot RARE technique was preferred to the multislice HASTE technique (p < .01).

CONCLUSION

The single-shot RARE technique shows fewer artifacts and is preferred to the multislice HASTE technique. However, both techniques show the same degree of sharpness of anatomic structures, both are able to reveal malignant diseases, and both provide enough information to determine a specific diagnosis.