Breath-hold MR cholangiography with snapshot techniques: prospective comparison with endoscopic retrograde cholangiography

Radiology. 1998 Mar;206(3):657-64. doi: 10.1148/radiology.206.3.9494483.


Purpose: To compare findings with magnetic resonance (MR) cholangiography with rapid acquisition with relaxation enhancement (RARE) and half-Fourier acquisition with single-shot turbo spin-echo (hereafter, half Fourier RARE) snapshot imaging techniques to those with endoscopic retrograde cholangiography (ERC).

Materials and methods: Heavily T2-weighted thick-section (RARE) and thin-section (half-Fourier RARE) MR cholangiography were performed prospectively, on a 1.5-T imager, in the biliary tree of 61 consecutive patients before ERC. Findings at ERC were considered the standard of reference. The radiologist and endoscopist were blinded to each other's report. On- and off-site MR cholangiographic readings were performed to detect stones (n = 24), biliary dilatation (n = 34), or stenosis (n = 36).

Results: The sensitivity and specificity of MR cholangiography, respectively, calculated on a lesion-by-lesion basis, were 92.3% and 95.8% for cholangiolithiasis, 94.1% and 92.6% for duct dilatation, and 88.8% and 84.0% for stenosis. With snapshot MR cholangiography, on a patient-by-patient basis, differentiation between normal (n = 15) and abnormal (n = 46) results yielded a sensitivity of 92.4%, a specificity of 83.4%, and a positive predictive value of 95.6%. Pitfalls were caused by flow artifacts, compression by vessels, and low contrast between calculi and surrounding parenchyma.

Conclusion: Snapshot MR cholangiography allowed noninvasive, accurate detection of biliary stones, strictures, and dilatation similar to that with ERC. Discrepancies regarding low-grade dilatation and strictures had no clinical relevance at retrospective review.

Publication types

  • Comparative Study

MeSH terms

  • Bile Duct Diseases / diagnosis*
  • Bile Duct Diseases / diagnostic imaging
  • Cholangiography / methods*
  • Cholelithiasis / diagnosis*
  • Cholelithiasis / diagnostic imaging
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / diagnostic imaging
  • Dilatation, Pathologic / diagnosis
  • Dilatation, Pathologic / diagnostic imaging
  • Female
  • Fourier Analysis
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity
  • Signal Processing, Computer-Assisted