Preoperative evaluation of the cystic duct for laparoscopic cholecystectomy: comparison of navigator-gated prospective acquisition correction- and conventional respiratory-triggered techniques at free-breathing 3D MR cholangiopancreatography

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• 作者：Ryo Itatani (1) (2)
  Tomohiro Namimoto (2)
  Hiroo Kajihara (1)
  Akira Yoshimura (1)
  Kazuhiro Katahira (1)
  Jiro Nasu (3)
  Ikuo Matsushita (4)
  Fumi Sakamoto (2)
  Masafumi Kidoh (5)
  Yasuyuki Yamashita (2)
  
• 关键词：Magnetic resonance cholangiopancreatography (MRCP) ; Gallbladder ; Cystic duct ; Navigator ; gated ; Respiratory triggered
• 刊名：European Radiology
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：23
• 期：7
• 页码：1911-1918
• 全文大小：347KB
• 参考文献：1. Ausch C, Hochwarter G, Taher M et al (2005) Improving the safety of laparoscopic cholecystectomy: the routine use of preoperative magnetic resonance cholangiography. Surg Endosc 19:574-80 CrossRef
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  4. Soto JA, Barish MA, Alvarez O, Medina S (2000) Detection of choledocholithiasis with MR cholangiography: comparison of three-dimensional fast spin-echo and single- and multisection half-Fourier rapid acquisition with relaxation enhancement sequences. Radiology 215:737-45
  5. Reinhold C, Guibaud L, Genin G, Bret PM (1995) MR cholangiopancreatography: comparison between two-dimensional fast spin-echo and three-dimensional gradient-echo pulse sequences. J Magn Reson Imaging 5:379-84 CrossRef
  6. Hricak H, Filly RA, Margulis AR, Moon KL, Crooks LE, Kaufman L (1983) Work in progress: nuclear magnetic resonance imaging of the gallbladder. Radiology 147:481-84
  7. Irie H, Honda H, Kuroiwa T et al (2001) Pitfalls in MR cholangiopancreatographic interpretation. Radiographics 21:23-7
  8. Choi JW, Kim TK, Kim KW et al (2003) Anatomic variation in intrahepatic bile ducts: an analysis of intraoperative cholangiograms in 300 consecutive donors for living donor liver transplantation. Korean J Radiol 4:85-0 CrossRef
  9. Uchiyama K, Tani M, Kawai M, Ueno M, Hama T, Yamaue H (2006) Preoperative evaluation of the extrahepatic bile duct structure for laparoscopic cholecystectomy. Surg Endosc 20:1119-123 CrossRef
  10. Yamashita Y, Abe Y, Tang Y, Urata J, Sumi S, Takahashi M (1997) In vitro and clinical studies of image acquisition in breath-hold MR cholangiopancreatography: single-shot projection technique versus multislice technique. AJR Am J Roentgenol 168:1449-454 CrossRef
  11. Taourel P, Bret PM, Reinhold C, Barkun AN, Atri M (1996) Anatomic variants of the biliary tree: diagnosis with MR cholangiopancreatography. Radiology 199:521-27
  12. Mutlu H, Basekim CC, Silit E et al (2005) Value of contrast-enhanced magnetic resonance cholangiography in patients undergoing laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 15:195-98, discussion 198-201 CrossRef
  13. Coenegrachts KL, Hoogeveen RM, Vaninbroukx JA et al (2004) High-spatial-resolution 3D balanced turbo field-echo technique for MR angiography of the renal arteries: initial experience. Radiology 231:237-42 CrossRef
  14. Asbach P, Dewey M, Klessen C et al (2006) Respiratory-triggered MRCP applying parallel acquisition techniques. J Magn Reson Imaging 24:1095-100 CrossRef
  15. Morita S, Ueno E, Suzuki K et al (2008) Navigator-triggered prospective acquisition correction (PACE) technique vs. conventional respiratory-triggered technique for free-breathing 3D MRCP: an initial prospective comparative study using healthy volunteers. J Magn Reson Imaging 28:673-77 CrossRef
  
• 作者单位：Ryo Itatani (1) (2)
  Tomohiro Namimoto (2)
  Hiroo Kajihara (1)
  Akira Yoshimura (1)
  Kazuhiro Katahira (1)
  Jiro Nasu (3)
  Ikuo Matsushita (4)
  Fumi Sakamoto (2)
  Masafumi Kidoh (5)
  Yasuyuki Yamashita (2)
  
  1. Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto, 862-0965, Japan
  2. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan
  3. Department of Digestive Surgery, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto, 862-0965, Japan
  4. Department of Gastroenterological Medicine, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto, 862-0965, Japan
  5. Department of Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto, 863-0046, Japan
  
• ISSN：1432-1084

文摘

Objective To evaluate the quality of magnetic resonance cholangiopancreatography (MRCP) images obtained with a three-dimensional navigator-gated (NG) technique and compare findings with conventional respiratory-triggered (RT) images in pre-laparoscopic cholecystectomy patients. Methods Turbo-spin-echo (TSE) RT-MRCP (average 242?s) and balanced turbo-field-echo (bTFE) NG-MRCP (average 263?s) were acquired at 1.5-T MRI for 49 pre-laparoscopic cholecystectomy patients. Two radiologists independently assessed image quality, visibility of anatomical structures, common bile duct (CBD) stones, and signal-to-noise ratios (SNRs). Interobserver agreement was also evaluated. Results The anatomical details of the cystic duct were clearly demonstrated in 33 (67.3?%, reader A) and 35 (71.4?%, reader B) patients on RT-MRCP, and in 45 (91.8?%) and 44 (89.7?%) patients on NG-MRCP. On NG-MRCP, visualisation of the cystic duct (3.22/3.12), its origin (3.57/3.55), and the gallbladder(3.61/3.59) was statistically better than on RT-MRCP (2.90/2.78, 3.29/3.12, 2.98/2.88, respectively). The overall image quality was statistically better on NG-MRCP than RT-MRCP. Each technique identified the presence of CBD stones in all affected patients. The SNR was significantly higher on NG-MRCP (CHD 22.40, gallbladder 17.13) than RT-MRCP (CHD 17.05, gallbladder 9.30). Interobserver agreement was fair to perfect. Conclusion Navigator-gated MRCP is more useful than respiratory-triggered MRCP for evaluating the gallbladder and cystic duct in patients scheduled for laparoscopic cholecystectomy. Key Points -Magnetic resonance cholangiopancreatography (MRCP) provides important cystic duct information before laparoscopic cholecystectomy. -Navigator-gated (NG) MRCP images were better than conventional respiratory-triggered (RT) MRCP. -The signal-to-noise ratio was significantly higher for NG-MRCP than for conventional RT-MRCP. -Balanced turbo-field-echo NG-MRCP is useful for evaluating the gallbladder and cystic duct.