Abstract 487: Diagnostic Value of Three-dimensional Thin Slice MR Cholangiopancreatography versus Single Shot MR Cholangiopancreatography
AUTHORS:
F.A. Timmer, MD, J. Stoker, MD, A. Niemans, MD, M.C. Schoemaker, MD, W. Roolker, PhD, G.J. Den Heeten, MD, PhD.
ABSTRACT:
PURPOSE: To assess the diagnostic value of three-dimensional thin slice (3D)MR Cholangiopancreatography (MRCP) versus Single Shot(SS)MRCP using endoscopic retrograde cholangiopancreatography (ERCP) as gold standard.
METHOD AND MATERIALS: 50 consecutive adult patients suspected to have pancreatico-biliary disease were examined. At a 1 Tesla (Philips T10 NT) system both a multi thin slice (3D) and a breath-hold (Single Shot) MRCP technique were performed. In the multi thin slice technique both source images and maximum intensity projections were examined. Two radiologists blinded to clinical information viewed both MRCP techniques independantly with an interval of at least 1 month. Measure of correlation between each of the techniques and the inter observer agreement were computed. ERCP was used as gold standard.
RESULTS: ERCP showed 30% malignant obstructions, 30% calculi in the common bile duct, 8% miscellaneous disorders and in 32% no abnormalities. A significant higher diagnostic value of the 3D MRCP technique over the SS MRCP technique (p|P(0,05)using the Mann-Whitney U test was found. Obstruction due to tumor was shown in 30% of patients and calculi in the common bile duct were shown also in 30% of patients employing the 3D MRCP technique and in 30% of patients and 21% of patients respectively using the SS MRCP technique. Sensitivity and specificity in distinguishing calculi in the common bile duct by 3D MRCP and SS MRCP were 100%, 100%, 70% and 100% respectively. The inter observer agreement for 3D MRCP was good for all diagnosis at a Kappa value ranging from 0.76 to 0.90 but bad to moderate for the SS MRCP at a Kappa value ranging from 0.20 to 0.63.
CONCLUSIONS: Although the 3D MRCP multislice technique is more time consuming than the SS MRCP breath-hold technique at a 1 Tesla (Philips T10 NT) system it is advisable to use thin slice 3D MRCP in order not to misdiagnose calculi in the common bile duct. A better inter observer agreement is reached employing the 3D MRCP technique.
