JeongHee Yoon

MRI including MRCP is a non-invasive modality to evaluate the bile duct. 

Federica Vernuccio

Biliary MRI has a 95% sensitivity and 97% specificity for the detection of biliary dilatation. The purposes of this presentation are:–  to describe imaging features of various obstructive and non-obstructive biliary diseases, providing tips for distinction between dilated bile duct pathologies;– to demonstrate the spectrum of imaging findings of focal or diffuse thickening of gallbladder wall and biliary cystadenoma/carcinoma;– to show other uncommon clinical scenarios where MRI may be useful to demonstrate biliary tree diseases.

Christopher Sonnenday

Maxime Ronot

Selected challenging cases of biliary disease will be presented and discuss. Cases will illustrate the complex diagnostic process and work-up of patients with bile duct anomalies.

Myles Todd Taffel¹, Andrew Rosenkrantz¹, Jonathan Foster¹, Jay Karajgikar¹, Paul Smereka¹, Thomas Mulholland¹, Hoi Cheng Zhang¹, Felicia Calasso¹, Rebecca Anthopolos², Kun Qian², and Hersh Chandarana^1
1Radiology, NYU Langone Medical Center, New York, NY, United States, ²NYU Langone Medical Center, New York, NY, United States

Previous work has demonstrated inferior abdominal MRI image quality in non-English speaking patients who require a translator.  While a translator may be helpful, they are often interpreting remotely via a telephone and may be unfamiliar with the intricate MRI breathing instructions.  As the result of the patient watching an instructional video explaining the MRI procedure in their primary language, image quality improves to match that of studies performed in primary English speaking patients. 

Sherry Huang¹, Yong Chen², Reid Bolding³, Leonardo Kayat Bittencourt⁴, Mark Griswold², and Rasim Boyacioglu^2
1Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States, ²Radiology, Case Western Reserve University, Cleveland, OH, United States, ³Physics, Case Western Reserve University, Cleveland, OH, United States, ⁴University Hospitals Cleveland Medical Center, Cleveland, OH, United States

This study presents a Pilot Tone (PT) based free-breathing technique for two-dimensional simultaneous quantification of T1, T2, T2*, fat fraction (FF), water fraction (WF), and off-resonance. This technique integrates quadratic RF phase-based Magnetic Resonance Fingerprinting (qRF-MRF) and PT navigator to retrospectively provide simultaneous quantification of multiple tissue properties in the abdomen at end-inhalation and end-expiration states.

Nobuyuki Kawai¹, Yoshifumi Noda¹, Kimihiro Kajita², Hiroshi Kawada¹, and Masayuki Matsuo^1
1Radiology, Gifu University, Gifu, Japan, ²Radiology Services, Gifu University Hospital, Gifu, Japan

MR cholangiopancreatography (MRCP) plays an essential role in the noninvasive assessment of the biliary and pancreatic duct systems. Although the conventional respiratory-triggered three-dimensional turbo spin-echo (RT-3D-TSE) MRCP sequence has an excellent duct-to-periductal tissue contrast, the long acquisition time, over 5 minutes, has been a clinical burden. We assessed two types of ultrafast MRCP within 30 seconds of scan time. Breath-hold 3D gradient- and spin-echo (GRASE) MRCP provided better image quality and a reduced number of poor or non-diagnostic images compared to RT-3D-TSE MRCP highly accelerated with optimized integrated combination with parallel imaging and compressed-sensing technique (Compressed SENSE).

Neeraja Mahalingam¹, George Ralli², Gerard Ridgway², Andrew Trout^3,4,5, and Jonathan Dillman^3,4,6
1Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ²Perspectum Ltd., Oxford, United Kingdom, ³Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States, ⁴Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁵Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States, ⁶Center for Autoimmune Liver Disease, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Comparison of the performance of different methods of acquiring three-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) data have been largely qualitative. MRCP+ prototype software (Perspectum Ltd.; Oxford, UK) was used to derive quantitative biliary tree metrics from 3D MRCP acquired using three different methods. Intra-class correlation coefficients (ICCs) demonstrated strong agreement on biliary tree volume, median intrahepatic duct diameters, number of ducts, and length of dilations between 3D FSE and CS-FSE MRCP (ICCs=0.84-0.93); there was slightly less agreement between CS-FSE and 3D GRASE MRCP. Our results suggest that CS-FSE provides comparable visualization of the biliary system to conventional 3D FSE MRCP.

Hidemitsu Sotozono¹, Akihiko Kanki¹, Kazuya Yasokawa¹, Akira Yamamoto¹, Tsutomu Tamada¹, and Yu Ueda^2
1Radiology, Kawasaki Medical School, Kurashiki, Japan, ²Philips Japan, Tokyo, Japan

Retrospective study included 46 patients without pancreatic disorders including pancreatic tumor and acute pancreatitis who underwent 3T abdominal multi-parametric MRI including cine-dynamic  with spatially selective inversion recovery pulse and proton density fat fraction in 3D mDIXON quant (PDFF (%)). Pancreatic exocrine function was assessed as secretion grade (SG) based on the travel distance of inflowing pancreatic juice in the main pancreatic duct on cine-dynamic MRCP. The negative correlation between PDFF of the pancreas and SG estimated by cine-dynamic MRCP with spatially selective IR pulse suggests an association between pancreatic steatosis and impaired pancreatic exocrine function.

Jingjing Liu¹, Mengyue Huang¹, Jingliang Cheng¹, and Jinxia Zhu^2
1Department of MR Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²MR Collaboration, Siemens Healthcare Ltd, Beijing, China

We investigated the feasibility of using and the resultant image quality of zoomed diffusion-weighted echo-planar imaging (z-EPI) for hilar cholangiocarcinoma assessments. Compared with conventional single-shot EPI (c-EPI), z-EPI showed better delineation of anatomic structures in the hepatic hilar region, better lesion conspicuity, and overall higher image quality. Bile duct wall lesion delineations and lumens were also improved in z-EPI in four of 16 patients. These findings suggest that z-EPI may be preferred for improved imaging of hilar cholangiocarcinoma.