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Isotropic 3D T2-Weighted MR Cholangiopancreatography with Parallel Imaging: Feasibility Study

Jingbo Zhang1, Gary M. Israel2, Elizabeth M. Hecht3, Glenn A. Krinsky4, James S. Babb3 and Vivian S. Lee3

1 Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., Rm. C278, New York, NY 10021.
2 Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520.
3 Department of Radiology, New York University Medical Center, New York, NY 10021.
4 Department of Diagnostic Imaging, Valley Health System, Ridgewood, NJ 07450.


Figure 1
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  		Fig. 1A —56-year-old woman with cystic mass in pancreatic head. MR images show regions of interest (circles) selected for data analysis in common bile duct and liver. Coronal thick-slab 2D turbo spin-echo image.

 

Figure 2
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  		Fig. 1B —56-year-old woman with cystic mass in pancreatic head. MR images show regions of interest (circles) selected for data analysis in common bile duct and liver. Single-source coronal 3D turbo spin-echo image.

 

Figure 3
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  		Fig. 2A —49-year-old man with gallstones. MR images show layering gallstones (black arrows), cystic duct insertion (thin white arrows), common bile duct bifurcation, and pancreatic duct tortuosity (thick white arrows). Maximum intensity projections were obtained in oblique axial planes for better delineation of layering gallstones and tortuous pancreatic duct. Coronal thick-slab 2D turbo spin-echo image.

 

Figure 4
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  		Fig. 2B —49-year-old man with gallstones. MR images show layering gallstones (black arrows), cystic duct insertion (thin white arrows), common bile duct bifurcation, and pancreatic duct tortuosity (thick white arrows). Maximum intensity projections were obtained in oblique axial planes for better delineation of layering gallstones and tortuous pancreatic duct. Oblique axial maximum-intensity-projection 3D turbo spin-echo image obtained with breath-hold.

 

Figure 5
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  		Fig. 2C —49-year-old man with gallstones. MR images show layering gallstones (black arrows), cystic duct insertion (thin white arrows), common bile duct bifurcation, and pancreatic duct tortuosity (thick white arrows). Maximum intensity projections were obtained in oblique axial planes for better delineation of layering gallstones and tortuous pancreatic duct. Oblique axial maximum-intensity-projection 3D turbo spin-echo image obtained with patient breathing freely.

 

Figure 6
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  		Fig. 3A —67-year-old woman with cholangiocarcinoma. MR images show obstructing mass at hepatic duct confluence and marked intrahepatic biliary dilation. Higher order of intrahepatic bile duct branches is visible with 3D compared with 2D images. Coronal thick-slab 2D turbo spin-echo image.

 

Figure 7
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  		Fig. 3B —67-year-old woman with cholangiocarcinoma. MR images show obstructing mass at hepatic duct confluence and marked intrahepatic biliary dilation. Higher order of intrahepatic bile duct branches is visible with 3D compared with 2D images. Maximum-intensity-projection 3D image obtained with breath-hold.

 

Figure 8
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  		Fig. 3C —67-year-old woman with cholangiocarcinoma. MR images show obstructing mass at hepatic duct confluence and marked intrahepatic biliary dilation. Higher order of intrahepatic bile duct branches is visible with 3D compared with 2D images. Free-breathing 3D turbo spin-echo image.

 

Figure 9
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  		Fig. 4A —42-year-old man with right upper quadrant pain. MR images show pancreas divisum and small dilated pancreatic side branches. Coronal thick-slab 2D turbo spin-echo image.

 

Figure 10
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  		Fig. 4B —42-year-old man with right upper quadrant pain. MR images show pancreas divisum and small dilated pancreatic side branches. Postprocessed 3D maximum-intensity-projection image obtained with breath-hold.

 

Figure 11
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  		Fig. 4C —42-year-old man with right upper quadrant pain. MR images show pancreas divisum and small dilated pancreatic side branches. Free-breathing 3D turbo spin-echo image best shows pancreas divisum (white arrow) and small dilated pancreatic side branches (black arrow).

 

Figure 12
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  		Fig. 5A —63-year-old man with pancreatic carcinoma. MR images show stricture (arrow, B) of common bile duct caused by pancreatic carcinoma. Three-dimensional images have similar diagnostic quality, and both are superior to 2D thick-slab image. Coronal thick-slab 2D turbo spin-echo image obtained with breath-hold.

 

Figure 13
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  		Fig. 5B —63-year-old man with pancreatic carcinoma. MR images show stricture (arrow, B) of common bile duct caused by pancreatic carcinoma. Three-dimensional images have similar diagnostic quality, and both are superior to 2D thick-slab image. Maximum-intensity-projection 3D image obtained with breath-hold.

 

Figure 14
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  		Fig. 5C —63-year-old man with pancreatic carcinoma. MR images show stricture (arrow, B) of common bile duct caused by pancreatic carcinoma. Three-dimensional images have similar diagnostic quality, and both are superior to 2D thick-slab image. Free-breathing 3D turbo spin-echo image. Clarity of ducts is less than in B, probably because of motion artifact associated with respiration-triggered sequence.

 

Figure 15
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  		Fig. 6A —56-year-old woman with chronic pancreatitis and cystic mass in pancreas. Maximum intensity projections of free-breathing 3D turbo spin-echo images show multiloculated cystic mass (arrows) in uncinate process. Coronal maximum intensity projection shows pancreatic head partially obscured by excessive fluid signal in duodenal bulb.

 

Figure 16
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  		Fig. 6B —56-year-old woman with chronic pancreatitis and cystic mass in pancreas. Maximum intensity projections of free-breathing 3D turbo spin-echo images show multiloculated cystic mass (arrows) in uncinate process. Thin maximum-intensity-projection image shows 3D data sets can be postprocessed to exclude overlying bowel.

 

Figure 17
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  		Fig. 6C —56-year-old woman with chronic pancreatitis and cystic mass in pancreas. Maximum intensity projections of free-breathing 3D turbo spin-echo images show multiloculated cystic mass (arrows) in uncinate process. Oblique maximum-intensity-projection image shows that with isotropic voxels, images can be reconstructed in any plane with preservation of spatial resolution.

 

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