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Rahmani V, Peltonen J, Hmelnikov D, Uosyte R, Männikkö S, Spillmann T, Ruohoniemi M. Three-dimensional magnetic resonance cholangiography is superior to two-dimensional single-shot magnetic resonance cholangiography for visualization and image quality of the feline and canine biliary tract: A postmortem study. Vet Radiol Ultrasound 2024. [PMID: 38608174 DOI: 10.1111/vru.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/20/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Magnetic resonance cholangiography (MRC) is an established diagnostic tool for noninvasive assessment of the biliary tract in humans. It has also been found to be feasible in companion animals, but no published studies have compared MRC sequences in veterinary medicine. The present study is part of a prospective, observational, analytical investigation on MR cholangiopancreatography performed on the donated bodies of 12 cats and eight dogs. The main aim of this study was to compare the images of 2D-SSh-TSE-MRC and 3D-TSE-MRC sequences for visualization and image quality of the feline and canine biliary tract. Both sequences are T2-weighted and noncontrast. Three independent readers scored the visibility of four segments of the biliary tract, namely the gallbladder (GB), cystic duct, common bile duct (CBD), and extrahepatic ducts, and the image quality of the two MRC sequences using five-point Likert scales. Wilcoxon signed-rank test was used to compare the scores between the MRC sequences separately for cats and dogs. Inter- and intraobserver agreements were measured using Gwet's AC2 with linear weighting. The 3D-TSE-MRC images were scored significantly higher than the 2D-SSh-TSE-MRC for both visibility and image quality (P < .001-.016 for cats, P = .008-.031 for dogs); the only exception was GB in dogs. In both cats and dogs, interobserver agreement for segment visibility and image quality ranged from slight to substantial in 2D-SSh-TSE-MRC and from poor to almost perfect in 3D-TSE-MRC. Most of the assessments (73% for segment visibility and 66% for image quality) had substantial to almost perfect intraobserver agreement. Findings from the current study support the use of 3D-TSE-MRC over 2D-SSh-TSE-MRC for evaluation of the feline and canine biliary tract, but further studies on live animals are warranted.
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Affiliation(s)
- Vahideh Rahmani
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Juha Peltonen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Dmitri Hmelnikov
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | | | - Thomas Spillmann
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Mirja Ruohoniemi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Rapid 3D breath-hold MR cholangiopancreatography using deep learning-constrained compressed sensing reconstruction. Eur Radiol 2023; 33:2500-2509. [PMID: 36355200 DOI: 10.1007/s00330-022-09227-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/15/2022] [Accepted: 10/09/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To compare the image quality of three-dimensional breath-hold magnetic resonance cholangiopancreatography with deep learning-based compressed sensing reconstruction (3D DL-CS-MRCP) to those of 3D breath-hold MRCP with compressed sensing (3D CS-MRCP), 3D breath-hold MRCP with gradient and spin-echo (3D GRASE-MRCP) and conventional 2D single-shot breath-hold MRCP (2D MRCP). METHODS In total, 102 consecutive patients who underwent MRCP at 3.0 T, including 2D MRCP, 3D GRASE-MRCP, 3D CS-MRCP, and 3D DL-CS-MRCP, were prospectively included. Two radiologists independently analyzed the overall image quality, background suppression, artifacts, and visualization of pancreaticobiliary ducts using a five-point 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 the periductal tissue and CBD were measured. The Friedman test was performed to compare the four protocols. RESULTS 3D DL-CS-MRCP resulted in improved SNR and CNR values compared with those in the other three protocols, and better contrast ratio compared with that in 3D CS-MRCP and 3D GRASE-MRCP (all, p < 0.05). Qualitative image analysis showed that 3D DL-CS-MRCP had better performance for second-level intrahepatic ducts and distal main pancreatic ducts compared with 3D CS-MRCP (all, p < 0.05). Compared with 2D MRCP, 3D DL-CS-MRCP demonstrated better performance for the second-order left intrahepatic duct but was inferior in assessing the main pancreatic duct (all, p < 0.05). Moreover, the image quality was significantly higher in 3D DL-CS-MRCP than in 3D GRASE-MRCP. CONCLUSION 3D DL-CS-MRCP has superior performance compared with that of 3D CS-MRCP or 3D GRASE-MRCP. Deep learning reconstruction also provides a comparable image quality but with inferior main pancreatic duct compared with that revealed by 2D MRCP. KEY POINTS • 3D breath-hold MRCP with deep learning reconstruction (3D DL-CS-MRCP) demonstrated improved image quality compared with that of 3D MRCP with compressed sensing or GRASE. • Compared with 2D MRCP, 3D DL-CS-MRCP had superior performance in SNR and CNR, better visualization of the left second-level intrahepatic bile ducts, and comparable overall image quality, but an inferior main pancreatic duct.
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Xiong J, Xia S, Peng G, Sun Y, Chen J, Cao K. Preoperative three-dimensional magnetic resonance cholangiopancreatography for choledocholithotomy. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2023. [DOI: 10.1016/j.jrras.2022.100499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Mazroua JA, Almalki YE, Alaa M, Alduraibi SK, Aboualkheir M, Aldhilan AS, Almushayti ZA, Aly SA, Basha MAA. Precision Mapping of Intrahepatic Biliary Anatomy and Its Anatomical Variants Having a Normal Liver Using 2D and 3D MRCP. Diagnostics (Basel) 2023; 13:diagnostics13040726. [PMID: 36832212 PMCID: PMC9955884 DOI: 10.3390/diagnostics13040726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/05/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023] Open
Abstract
Despite significant advances in hepatobiliary surgery, biliary injury and leakage remain typical postoperative complications. Thus, a precise depiction of the intrahepatic biliary anatomy and anatomical variant is crucial in preoperative evaluation. This study aimed to evaluate the precision of 2D and 3D magnetic resonance cholangiopancreatography (MRCP) in exact mapping of intrahepatic biliary anatomy and its variants anatomically in subjects with normal liver using intraoperative cholangiography (IOC) as a reference standard. Thirty-five subjects with normal liver activity were imaged via IOC and 3D MRCP. The findings were compared and statistically analyzed. Type I was observed in 23 subjects using IOC and 22 using MRCP. Type II was evident in 4 subjects via IOC and 6 via MRCP. Type III was observed equally by both modalities (4 subjects). Both modalities observed type IV in 3 subjects. The unclassified type was observed in a single subject via IOC and was missed in 3D MRCP. Accurate detection by MRCP of intrahepatic biliary anatomy and its anatomical variants was made in 33 subjects out of 35, with an accuracy of 94.3% and a sensitivity of 100%. In the remaining two subjects, MRCP results provided a false-positive pattern of trifurcation. MRCP competently maps the standard biliary anatomy.
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Affiliation(s)
- Jehan A. Mazroua
- Department of Diagnostic Radiology, Faculty of Human Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Yassir Edrees Almalki
- Division of Radiology, Department of Internal Medicine, Medical College, Najran University, Najran 61441, Saudi Arabia
- Correspondence:
| | - Mohamed Alaa
- Department of Diagnostic Radiology, Faculty of Human Medicine, Mansoura University, Mansoura 35516, Egypt
| | | | - Mervat Aboualkheir
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia
| | - Asim S. Aldhilan
- Department of Radiology, College of Medicine, Qassim University, Buraidah 52571, Saudi Arabia
| | - Ziyad A. Almushayti
- Department of Radiology, College of Medicine, Qassim University, Buraidah 52571, Saudi Arabia
| | - Sameh Abdelaziz Aly
- Department of Diagnostic Radiology, Faculty of Human Medicine, Benha University, Benha 13511, Egypt
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Three-dimensional static-fluid MR urography with gradient- and spin-echo (GRASE) at 3.0T: comparison of image quality and diagnostic performance with respiratory-triggered fast spin-echo (FSE). Abdom Radiol (NY) 2022; 47:1828-1839. [PMID: 35234996 PMCID: PMC9038886 DOI: 10.1007/s00261-022-03418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 11/05/2022]
Abstract
Purpose To compare the performance of 3D MRU based on a breath-hold gradient- and spin-echo (BH-GRASE) technique with conventional 3D respiratory-triggered FSE (RT-FSE) sequence in patients with urinary tract dilation. Methods We prospectively included 90 patients with urinary tract dilation who underwent both 3D BH-GRASE and RT-FSE MRU at 3T. The acquisition time of two MRU sequences was recorded. Three readers blinded to the protocols reviewed the image quality using a five-point scale and assessed the diagnostic performance related to urinary tract dilation. The relative contrast ratio (CR) between the urinary tract and adjacent area was measured quantitatively. Results Acquisition time was 14.8 s for BH-GRASE MRU and 213.6 ± 52.2 s for RT-FSE MRU. The qualitative image analysis demonstrated significant equivalence between the two MRU protocols. 3D BH-GRASE MRU better depicted bilateral renal calyces than RT-FSE MRU (p < 0.05). The CR values of the urinary tract were lower on BH-GRASE MRU compared with RT-FSE MRU (p < 0.05). There were excellent agreements in the assessment of urinary tract dilation between BH-GRASE and RT-FSE MRU, including the dilated degree, obstructive level, and obstructive imaging features (inter-sequence κ = 0.924–1). Conclusion 3D BH-GRASE MRU significantly decreased the acquisition time and achieved comparable image quality, urinary tract visualization, and diagnostic performance with conventional 3D RT-FSE MRU. Breath-hold 3D MRU with GRASE may provide a feasible evaluation of urinary tract dilation. Graphical abstract ![]()
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Yoen H, Lee JM, Lee SM, Kang HJ, Bae JS, Kim E, Peeters JM, Yoon JH. Comparisons between image quality and diagnostic performance of 2D- and breath-hold 3D magnetic resonance cholangiopancreatography at 3T. Eur Radiol 2021; 31:8399-8407. [PMID: 33884471 DOI: 10.1007/s00330-021-07968-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare the image quality and diagnostic performance of 2D MRCP to those of breath-hold 3D MRCP using compressed sensing (CS-MRCP) and gradient and spin-echo (GRASE-MRCP) at 3T. METHODS From January to November 2018, patients who underwent pancreatobiliary MRI including 2D MRCP and two breath-hold 3D MRCP using CS and GRASE at 3T were included. Three radiologists independently evaluated image quality, motion artifact, and pancreatic cyst conspicuity. Diagnostic performance was assessed for bile duct anatomic variation, bile duct, and pancreatic diseases using a composite algorithm as reference standards. Pancreatic lesion detectability and conspicuity were evaluated using JAFROC and generalized estimating equation analysis. RESULTS One hundred patients (male = 50) were included. Bile duct anatomic variation, bile duct and pancreatic diseases were present in respectively 31, 15, and 79 patients. Breath-hold 3D MRCP provided better image quality than 2D MRCP (3.5 ± 0.6 in 2D MRCP; 4.0 ± 0.7 in GRASE-MRCP and 3.9 ± 0.8 in CS-MRCP, p < 0.001 for both). There was no difference in motion artifact between 2D and breath-hold 3D MRCP (p = 0.1). Breath-hold 3D CS-MRCP provided better pancreatic cyst conspicuity than 2D MRCP (2.7 [95% CI: 2.5-3.0] vs. 2.3 [95% CI: 2.1-2.5], p = 0.001). There were no significant differences between the diagnostic performance of the three sequences in the detection of bile duct anatomic variation or pancreatic lesions (p > 0.05). CONCLUSION Breath-hold 3D MRCP with GRASE or CS can provide better image quality than 2D MRCP in a comparable scan time. KEY POINTS • Breath-hold 3D MRCP using compressed sensing (CS) or gradient and spin-echo (GRASE) provided a better image quality with less image blurring than 2D MRCP. • There were no significant differences between 2D MRCP and breath-hold 3D MRCP in either motion artifact or the number of non-diagnostic exams. • There were no significant differences between 2D MRCP and either type of breath-hold 3D MRCP in the diagnosis of bile duct anatomic variation or detection of pancreatic lesions.
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Affiliation(s)
- Heera Yoen
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea
| | - Sang Min Lee
- Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Gyunggi-do, 14068, Republic of Korea
| | - Hyo-Jin Kang
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea
| | - Jae Seok Bae
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea
| | - Eunju Kim
- Philips Healthcare, Seoul, 04637, Republic of Korea
| | | | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea.
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Jang W, Song JS, Kim SH, Yang JD. Comparison of Compressed Sensing and Gradient and Spin-Echo in Breath-Hold 3D MR Cholangiopancreatography: Qualitative and Quantitative Analysis. Diagnostics (Basel) 2021; 11:diagnostics11040634. [PMID: 33915832 PMCID: PMC8065789 DOI: 10.3390/diagnostics11040634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 02/07/2023] Open
Abstract
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 (p = 0.004) and left 2nd level IHD (p < 0.001), mid PD (p = 0.003), and distal PD (p = 0.041). Image quality degradation was less with BH-GRASE-MRCP than BH-CS-MRCP (p = 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 (p < 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.
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Affiliation(s)
- Weon Jang
- Department of Radiology, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea; (W.J.); (S.H.K.)
| | - Ji Soo Song
- Department of Radiology, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea; (W.J.); (S.H.K.)
- Research Institute of Clinical Medicine, Jeonbuk National University, Jeonju 54907, Korea
- Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju 54907, Korea
- Correspondence: ; Tel.: +82-63-250-1150
| | - Sang Heon Kim
- Department of Radiology, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea; (W.J.); (S.H.K.)
| | - Jae Do Yang
- Department of Surgery, Jeonbuk National University Medical School, Jeonju 54907, Korea;
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