MRCP imaging at 3.0 T vs. 1.5 T: preliminary experience in healthy volunteers

The diagnostic MRCP examination: overcoming technical challenges to ensure clinical success

The magnetic resonance cholangiopancreatography (MRCP) examination has all but replaced the diagnostic endoscopic retrograde cholangiopancreatography (ERCP) examination for imaging the biliary tree and pancreatic ducts in many practical aspects of the clinical setting. Despite this increase in popularity, many magnetic resonance imaging (MRI) radiographers still find aspects of the MRCP examination quite challenging. The aim of this tutorial paper is to provide useful technical advice on how to overcome such perceived challenges and thus produce a successful diagnostic MRCP examination. This paper will be of interest to novice MRI radiographers who are at the beginning of their learning curve in MRCP examination. Other MRI radiographers who are interested in practical tips for protocol variations may also find the paper useful.

Biliary tract depiction in living potential liver donors at 3.0-T magnetic resonance cholangiography

OBJECTIVES

To prospectively evaluate accuracy of biliary anatomy depiction and quality of biliary tract visualization of magnetic resonance cholangiography (MRC) at 3.0 T in living potential liver donors (LPLDs).

MATERIALS AND METHODS

Our institutional review board approved this study and did not require patient's informed consent. Thirty-three LPLDs underwent MRC at 3.0-T magnetic resonance and intraoperative cholangiography as the reference standard. MRC protocol included breath-hold rapid acquisition with relaxation enhancement (RARE) and respiratory-triggered 3-dimensional turbo spin-echo (TSE) T2-weighted sequence. Two readers independently analyzed 2 MRC image sets with a 2-week interval for delineating biliary anatomy and scoring degree of visualization of biliary branches with a 4-point scale, and recorded the number of visible third-order branches. One month later, both readers independently evaluated combined both MRC image set to assess biliary anatomy.

RESULTS

Biliary anatomy was correctly depicted by RARE sequence in 28 (84.8%) and 26 LPLDs (78.8%), by TSE sequence in 27 (81.8%) and 26 (78.8%), and by combined both sequences in 27 (81.8%) and 28 (84.8%), for readers 1 and 2, respectively. The mean second-order branch visualization scores for 2 readers were significantly higher for RARE images than for TSE (2.23 vs. 1.68, P = 0.02; 2.05 vs. 1.54, P = 0.02, respectively). The mean numbers of visible third-order branches were significantly higher for RARE images than TSE for both readers (4.36 vs. 3.04, P = 0.03; 4.72 vs. 3.32, P = 0.03, respectively).

CONCLUSIONS

In LPLDs, MRC at 3.0 T with both RARE and TSE sequences enables accurate depiction of biliary anatomy. RARE sequence more clearly visualizes second- and third-order biliary branches than TSE sequence.

MR cholangiopancreatography: 1.5T versus 3T

Soon after its introduction in 1991, MR cholangiopancreatography has become an established diagnostic tool for the evaluation of the pancreaticobiliary ductal system at a field strength of 1.5T. It remains unclear whether MR cholangiopancreatography performed at 3T will benefit from the higher magnetic field strength or whether a field strength of 1.5T should continue to be considered the gold standard for MR cholangiopancreatography. This article reviews the current literature on the benefits and drawbacks of MR cholangiopancreatography at 3T compared with a standard field strength of 1.5T. Field strength-related artifacts that affect MR cholangiopancreatography at 3T also are discussed.