Postcontrast application of single breath-hold three-dimensional variable flip-angle fast spin-echo breath-hold magnetic resonance cholangiopancreatography for evaluating the pancreaticobiliary ductal system

Background: Magnetic resonance cholangiopancreatography (MRCP) is a widely used noninvasive imaging technique for evaluating the pancreaticobiliary ductal system, but its image quality is often affected by respiratory motion and background signal. The purpose of this study was evaluating the performance of contrast-enhanced single breath-hold three-dimensional variable flip-angle fast spin-echo breath-hold MRCP (3D SPACE BH MRCP) in examining patients with suspected pancreaticobiliary disease, with a specific focus on the resulting image quality. Methods: Forty patients prospectively underwent pre- and postcontrast (intravenous gadolinium) 3D SPACE BH MRCP during the portal venous and equilibrium phases. Quantitative analysis measured signal intensity [common bile duct (CBD), liver, and background], signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast ratio (CR). Two radiologists independently scored subjective image quality on a four-point scale. Statistical analyses included Wilcoxon signed-rank tests and kappa statistics. Results: As compared to precontrast sequences, postcontrast sequences demonstrated significant reductions in liver signal (-12.77%; P