MR cholangiography using a fast spin-echo technique: prospective evaluation in 20 patients

Purpose: To evaluate a MR cholangiographic technique using a non breath-hold fast spin-echo technique in patients with suspected bile duct obstruction. Material and Methods: Twenty patients with suspected bile duct obstruction were prospectively investigated with MR cholangiography using a T2-weighted non breath-hold fast spin-echo technique (TR = 8000-9000 mse, effective TE = 120-266 msec, ETL = 16-32, acquisition time = 1-3 min) with a body coil. Results of MR cholangiography were compared to those obtained with endoscopic retrograde cholangiography (n = 20 patients) and endoscopic sonography (n = 12 patients) that were considered as reference. Results : MR cholangiography provided high-quality images in 19 out of 20 cases (95 %). MR cholangiography had 100 % sensitivity, 100 % specificity and 100 % accuracy in the diagnosis of bile duct dilatation. MR cholangiography had 73 % sensitivity, 75 % specificity and 73 % accuracy in the diagnosis of bile duct obstruction. MR cholangiography failed to depict small stones (< 3 mm) of the main bile duct in 4 cases in which no bile duct dilatation was found. Conclusion: MR cholangiography using a non breath-hold fast spin-echo technique depicts bile duct dilatation with a degree of accuracy comparable to that achieved with endoscopic examination. In the absence of bile duct dilatation, small stones of the main bile duct may be undetected with MR cholangiography.