Prospective intraindividual comparison between respiratory-triggered balanced steady-state free precession and breath-hold gradient-echo and time-of-flight magnetic resonance imaging for assessment of portal and hepatic veins.
The purpose of this study was to compare respiratory-triggered balanced steady-state free precession (bSSFP) with breath-hold contrast-enhanced dynamic two-dimensional (2D) gradient-echo (GRE) and time-of-flight (TOF) magnetic resonance imaging (MRI) for portal and hepatic vein visualization and assessment of portal and hepatic venous variants. Sixty patients with liver disease underwent nonenhanced bSSFP and contrast-enhanced GRE, bSSFP, and TOF imaging. Contrast-to-noise ratios (CNRs) for portal and hepatic veins were measured. Two readers rated the quality of portal and hepatic vein visualization on a 5-point Likert scale. The diagnostic performance of each MRI series in the detection of portal and hepatic venous variants was assessed in 40/60 patients who also underwent contrast-enhanced multidetector-row computed tomography (MDCT). CNRs for portal and hepatic veins were highest on contrast-enhanced bSSFP images. Image quality of portal and hepatic veins was rated higher for nonenhanced bSSFP than for contrast-enhanced GRE (p<0.03) and TOF (p<0.003) and higher for contrast-enhanced than for nonenhanced bSSFP (p<0.003). Compared with MDCT, portal and hepatic venous variants were identified with an accuracy of 99% on bSSFP images, with an excellent interobserver agreement (kappa=0.97). Compared with MDCT, presence of surgically important portal and hepatic venous anatomical variants can be predicted with high accuracy on bSSFP images.
Willmann
Jürgen K
JK
Institute of Diagnostic Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland. willmann@stanford.edu
Göpfert
Kerstin
K
Lutz
Amelie M
AM
Nanz
Daniel
D
McCormack
Lucas
L
Petrowsky
Henrik
H
Seifert
Burkhardt
B
Hervo
Patrice
P
Marincek
Borut
B
Weishaupt
Dominik
D
D000328:Adult; D000368:Aged; D005260:Female; D006503:Hepatic Veins / Q000473:pathology*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology*; D011446:Prospective Studies; D012119:Respiration