| Purpose:To compare the image qualityof navigator-triggered(NT)3D MRcholangiopancreatography(MRCP)with and without a patient-adapted respiratory training,in clinical patients with painful pancreatobiliary disorders.Materials and methods:With institutional review board approval,hospitalized patients with painful pancreatobiliary disorders who were scheduled for MRCP study were prospectively enrolled.All patients gave written informed consent.The numerical rating scale(NRS)of abdominal pain during t&e examination was recorded Special patient-adapted respiratory training was conducted before the examination.A control group of patients was enrolled with the same criteria,who received ordinary instructions only(n=60 for each group).A subgroup of patients(n=10)underwent MRCP studies with ordinary instructions first and with patient-adapted training later.Acquisition time was recorded.General image quality,degree of artifacts and visualization of 12 segments of the pancreatobiliary tree were rated on a five-point scale and compared between the groups.Result:Both groups had similar NRS of pain.There was a significant improvement in image quality(p<0.01)as well as visualization of rightposterior hepatic duct(p=0.045),left lateral hepatic duct(p=0.037),and pancreatie duct(p<0.01 for head,body and tail segments)in patients receiving respiratory training.The other segments showed no significant differences.The percentage of patients with severe and extensive imaging artifacts decreased from 18.3%(11/60)to 8.3%(5/60).The acquisition time was shorter(175±54s vs 249±67s,p<0.01)in patients with respiratory training.Conclusion rPatient-adapted respiratory training improves the image quality of NT-MRCP in patients with painful pancreatobiliary disorders.Purpose:To compareimage quality,duct visibility and diagnostic performance compressed-sensing(CS)accelerated breath-hold(BH)3D MRCP,CS accelerated navigator-triggered(NT)MRCP and conventional 3D MRCP,ina prospective cohort of patients with pancreatic diseases.Material and methods:Institutional review board approval was acquired,and written informed consent was given by all patients.Eighty patients underwent 3D MRCP on a 3T MR scanner.CS-BH-MRCP,CS-NT-MRCP and conventional NT?MRCP were performed in random order.For each protocol,the acquisition time was recorded.Two radiologists evaluated the images independently in a blinded manner,concerning image quality and duct visibility.Receiver operating characteristic curves were used to compare the diagnostic performance of the three protocols.Results:for the CS-BH-MRCP,the acquisition time was 17 seconds,and for CS-NT-MRCP,the acquisition time was 134.1±33.5 seconds.Both were significantly shorter than conventional NT MRCP(364.7±78.4 seconds,both p<0.01).Respiratory artifacts were significantly lower for CS-BH-MRCP,compared to CS-NT-MRCP and conventional NT-MRCP(both p<0.01).The bile ducts visibility was comparable forall protocols,while CS-NT-MRCP and conventional NT-MRCP had better pancreatic duct visibility than CS-BH MRCP(all p<0.05).CS-NT MRCP had the highest diagnostic performance for diagnosing pancreatic duct abnormalities(mean Az value 0.943-0.983).Conclusions:CS-MRCP can be used in patients with pancreatic diseases.CS-NT-MRCP is better for diagnosing pancreatic diseases,compared to CS-BH-MRCP and conventional MRCP.Purpose:To evaluatethe feasibility of a modified 3D breath-hold(BH)compressed-sensing accelerated MRCP protocol(modified BH-CS-MRCP),and to compare the performance with the original BH-CS-MRCP and NT-CS-MRCP in a prospective cohort of clinical patients with pancreatic or biliary diseases..Material and methods:Institutional review board approval was acquired,and written informed consent was given by all patients.Eighty-two patients(including 7 non-cooperative patients)underwent 3D MRCP on a 3T MR scanner.The modified BH-CS-MRCP,the original BH-CS-MRCP and NT-CS-MRCPwere performed in each patientin random order.The acquisition time of each protocol was documented.Two radiologists independently evaluated the images in a blinded manner.A 5-point Likert-scalewas used to rate image quality,background suppression,duct visibility and diagnostic confidence.The Wilcoxon signed-rank test was used to compare the difference of the three protocols.Kappa coefficientswas used for inter-observer agreement.Receiver operating characteristic curves(ROC)was used to compare the diagnostic performance the three protocols.Results:For both BH-CS-MRCP protocols,theacquisition time was 17 seconds,and for NT-CS-MRCP,theacquisition time was 127.5±36.9 seconds.The incidence of major artifacts was low for all protocols(5.3%-8.0%)in cooperative patients.The two BH-CS-MRCP protocols had similar degree of background suppression(3.67±0.77 and 3.70±0.57 for for original and modified BH-CS-MRCP,respectively),both of which were inferior to NT-CS-MRCP(4.41±0.68,both p<0.001).Pancreatic duct and second-level branches of biliary duct were better visualized with modified BH-CS-MRCP and NT-CS-MRCP,compared to the original BH-CS-MRCP(all p<0.01).The diagnostic performance for bile duct abnormalities was similar with all three protocols(p=0.53-0.87).However,for pancreatic duct abnormalities,modified BH-CS-MRCP and NT-CS-MRCP showed significantly superior diagnostic performance(both p<0.01).NT-CS-MRCP had better image quality than both BH protocols in non-cooperative patients(both sions:Modified BH-CS-MRCP is feasible for diagnosing pancreatic and biliary diseases.NT-CS-MRCP demonstrated superior diagnostic performance in non-cooperative patients.Purpose:To evaluate and compare the image quality and diagnostic performance of three MRCP protocols including BH-CS,BH-GraSE and conventional navigator—triggered(NT)MRCP.Materials and Methods:Seventy-four patients were prospectively enrolled and went through the three MRCP protocols.The acquisition time of each protocol was recorded and compared.The pancreaticobiliary system was divided into 12 segments and evaluated on a 5-point scale by two radiologists.The patients were divided into subgroups according to the breath regularity and age.The imaging quality and the diagnostic performance of each MRCP protocol was compared.Results:The BH-MRCP decreased the scan time significantly(P<0.05).There is no significant difference among three MRCP protocols in imaging quality and diagnostic performance for patients younger than 55 years or with regular breath.The overall imaging score of GRASE-MRCP and CS-MRCP was significantly higher than that of the NT-MRCP for patients with irregular breath(4.283 and 4.283 vs.3.000,both P<0.05)and older than 55 years old(4.455 and 4.591 vs.3.659 both P<0.05).Compared to NT-MRCP,the diagnostic performance of BH-CS and BH-GraSE MRCP was significantly improved for both patients older than 55(AUC=0.958 and 0.954 vs.0.753,P=0.001 and 0.008)and patients with irregular breath(AUC=0.860 and 0.863 vs.0.572,both P<0.001).Conclusions:Compared to conventional NT-MRCP,the overall imaging quality and diagnostic performance of the BH-CS and BH-GraSE MRCP is non-inferior for patients with regular breath and significantly superior for patients with irregular breath. |
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