[Single shot fast spin echo sequence MRI cholangiopancreatography].
OBJECTIVE
To assess the value of single shot fast spin echo MR sequence (SS-FSE) in the morphological analysis of the biliary tree and pancreatic ducts and to compare its accuracy with other imaging methods.


METHODS
95 consecutive patients referred for clinical and/or biological suspicion of biliary obstruction were explored with MR cholangiopancreatography (MRCP). All patients were explored with a Signa 1.5 T GE MR unit, with High Gradient Field Strength and Torso Phased Array Coil. Biliary ducts were explored with SS-FSE sequence, coronal and oblique coronal 20 mm thick slices on a 256 x 256 matrix. Total acquisition time was 1 second. Native pictures were reviewed by two radiologists blinded to clinical information. In case of disagreement, a third radiologist's judgement was requested. In 88 cases, MRCP results were compared with direct biligraphy methods.


RESULTS
In all cases, MRCP produced high quality images without MIP or other post-processing methods. For detection of biliary tree distensions, the concordance value of MRCP was over 91% (Kappa 0.82). For detection of biliary tree and/or pancreatic duct obstruction, MR sensitivity was 100% and specificity 91%. The overall diagnostic concordance value of MRCP was > or = 93%. Difficulties in MRCP were caused by functional diseases or benign stenosis. MRCP accurately diagnosed all lithiasic obstructions starting from a stone size of 3 mm.


CONCLUSIONS
MRCP produces fastly high-quality images. As it is totally safe, it can be proposed as a first intention method in biliopancreatic duct explorations.
Service de Radiologie, Hôpital d'Adultes, CHU Nancy-Brabois, Vandoeuvre.
F
F
Lefèvre
P
P
Crouzet
H
H
Gaucher
F
F
Chapuis
S
S
Béot
H
H
Boccaccini
C
C
Bazin
D
D
Régent
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002137:Calculi / Q000175:diagnosis / Q000000981:diagnostic imaging; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002769:Cholelithiasis / Q000175:diagnosis / Q000000981:diagnostic imaging; D002779:Cholestasis / Q000175:diagnosis / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
Cholangio-pancréatographie IRM en séquence single shot fast spin echo.