title: Usefulness of 3D balanced turbo-field-echo MR sequence evaluating the branching pattern of the intrahepatic bile ducts: comparison with drip infusion CT cholangiography.
abstract: For liver surgery, it is crucial to preoperatively examine the course of the right posterior bile duct. While MR cholangiopancreatography (MRCP) can only visualize the bile ducts, 3D balanced turbo-field-echo (BTFE) sequence clearly depicts the bile ducts and portal veins as well as drip infusion CT cholangiography (DIC-CT), without contrast media. We evaluated whether BTFE could substitute for DIC-CT.
  
  
  
  Thirty patients undergoing MRCP and BTFE on 1.5-T MR and DIC-CT were evaluated. Two readers retrospectively evaluated the branching pattern (supra-type: A-C or infra-type: D-E) and scored the degree of confidence and motion artifacts using a 3-point scale for the three 2-mm-thick reconstructed images.
  
  
  
  The bile duct diameter did not differ between DIC-CT and MRCP (p = 0.07). Five patients (17%) had intrahepatic biliary dilatation (>3 mm). The A, B, C, D, and E types were diagnosed in 21, 6, 1, 1, and 1 patient, respectively (28 supra-types and 2 infra-types) on DIC-CT. For DIC-CT, MRCP, and BTFE, the mean motion artifact scores were 3.0/3.0, 2.7/2.6, and 2.9/2.8, respectively. The mean diagnostic confidence scores were 2.9/2.9, 2.4/2.4, and 2.9/2.8, respectively, with no difference between DIC-CT and BTFE. The concordance between DIC-CT and BTFE was high (infra- or supra-type: κ = 1.00/1.00, A-E: κ = 0.86/0.66), but it was poor between DIC-CT and MRCP (infra- or supra-type: κ = 0.35/-0.05, A-E: κ = 0.33/0.41) for both readers.
  
  
  
  Similar to DIC-CT, the BTFE MR sequence had high diagnostic accuracy regarding the branching pattern of the intrahepatic bile duct, especially for the supra/infraportal type.
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan. eternal@fj9.so-net.ne.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ozawa
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Ohta
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Sekiguchi
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Omata
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Misugi
authors.initials: M
authors.lastname: Urano
authors.affiliation: Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods*; D004067:Digestive System Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Branching pattern of the intrahepatic bile duct; Drip infusion CT cholangiography (DIC-CT); Supraportal/infraportal pattern; Three-dimensional balanced turbo-field-echo (3D-BTFE) MR sequence