MR cholangiopancreatography of pancreaticobiliary diseases: Comparison of single-shot RARE and multislice HASTE sequences

AIMS: We prospectively compared two breath-hold magnetic resonance cholangi opancreatography (MRCP) sequences: single-shot rapid acquisition with relax ation enhancement (RARE) and multislice half-Fourier acquisition single-sho t turbo spin echo (HASTE) in imaging the pancreaticobiliary system. PATIENTS AND METHODS: The diagnostic accuracy of single-shot RARE and multi slice WASTE was studied in 34 subjects who had undergone conventional chola ngiopancreatography. Overall image quality, duct conspicuity, image artifac t, signal intensity and contrast-to-noise ratios were assessed independentl y by two radiologists who were unaware of the underlying diagnosis. RESULTS: Both sequences had comparable diagnostic accuracy regarding a norm al biliary system, choledocholithiasis, extra-hepatic and intra-hepatic str ictures, Single-shot RARE was superior to multislice HASTE in diagnosing a normal pancreatic system, pancreatic and intrahepatic duct strictures, whil e providing significantly better image quality (mean +/- SE 3.7 +/- 0.07 vs 3.3 +/- 0.08: P = 0.02) and significantly less image artifact (mean +/- SE 3.6 +/- 0.07 vs 3.2 +/- 0.08: P = 0.01), Single-shot RARE provided signifi cantly better duct conspicuity regarding the pancreatic duct within the bod y (2.7 +/- 0.2 vs 2.1 +/- 0.2: P = 0.003) and tail (2.4 +/- 0.2 vs 1.6 +/- 0.2; P = 0.0001), as well as the intrahepatic ducts (3.0 +/- 0.1 vs 2.6 +/- 0.1: P = 0.004) but there was no significant difference regarding the rema inder of the biliary tree. CONCLUSION: Single-shot RARE provides superior image quality, duct conspicu ity with the added advantage of less image artifact and shorter acquisition time, However, volume averaging can cause common bile duct stones to be mi ssed. Therefore, multislice HASTE sequences should still be acquired if cho ledocholithiasis is suspected. Larger studies are required to assess the di agnostic efficacy of single-shot RARE sequences in pancreatic duct and intr a-hepatic duct disease. (C) 2000 The Royal College of Radiologists.