Comparison and evaluation of the efficacy of compressed SENSE (CS) and gradient- and spin-echo (GRASE) in breath-hold (BH) magnetic resonance cholangiopancreatography (MRCP)

Abstract

Contract grant sponsor: Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine; Contract grant number: 2017-I2M-1-001; Contract grant sponsor: Outstanding Youth Fund of Peking Union Medical College Hospital; Contract grant number: JQ201704; Contract grant sponsor: National Natural Science Foundation of China; Contract grant number: 81871512; Contract grant sponsor: National Public Welfare Basic Scientific Research Program of Chinese Academy of Medical Sciences; Contract grant numbers: 2018PT32003 and 2017PT32004.

Background: Both compressed-sensing (CS) and gradient- and spin-echo (GRASE) sequences can achieve 3D magnetic resonance cholangiopancreatography (MRCP) with a single breath-hold (BH). This work hypothesized that compared with conventional navigator-triggered (NT)-MRCP, the two BH-MRCP protocols, GRASE and CS, may provide better imaging quality, especially for patients with irregular breathing.

Purpose: To evaluate and compare the image quality and diagnostic performance of three MRCP protocols.

Study type: Prospective.

Subjects: Seventy-four patients suspected to have duct-related pathologies were enrolled.

Field strength: 3.0T.

Sequences: NT-MRCP, BH-CS-MRCP, and BH-GRASE-MRCP.

Assessment: Breath regularity was evaluated subjectively according to the respiratory waves. The acquisition time was compared. The pancreaticobiliary system was divided into 12 segments and evaluated on a 5-point scale. The diagnostic performance of the three MRCPs was evaluated and compared.

Statistical tests: The Friedman test with a post-hoc test, receiver operating characteristic (ROC) curve analysis, McNemar test, and Kendall's W test were used.

Results: The BH-MRCP decreased the scan time significantly (P < 0.05). The overall imaging scores of GRASE-MRCP and CS-MRCP were significantly higher than that of NT-MRCP for patients with irregular breathing (4.283 and 4.283 vs. 3.000, both P < 0.05). Compared with NT-MRCP, the diagnostic performance of BH-CS and BH-GRASE MRCP was significantly improved for patients with irregular breathing (AUC = 0.860 and 0.863 vs. 0.572, both P < 0.001).

Data conclusion: Compared with conventional NT-MRCP, the overall imaging quality and diagnostic performance of BH-CS and BH-GRASE MRCP were not significantly different for patients with regular breathing and significantly superior for patients with irregular breathing.

Level of evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:824-832.

Keywords: biliary tract; breath holding; magnetic resonance cholangiopancreatography; three-dimensional imaging.