• Jung Hoon Kim, Seong Sook Hong, Hyo Won Eun, Joon Koo Han, and Byung Ihn Choi.
• Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehang-no, Chongno-gu, Seoul 110-744, Republic of Korea. Jhkim2008@gmail.com
• Eur J Radiol. 2012 Apr 1; 81 (4): e513-8.

PurposeTo assess the clinical usefulness of free-breathing 3D MRCP in non-cooperative patients compared conventional breath-hold 2D MRCP.Materials And MethodsWe performed FB navigator-triggered 3D MRCP using prospective acquisition correction and BH 2D MRCP in 48 consecutive, non-cooperative patients among 772 patients. Thirteen patients had malignant obstruction. Two radiologists independently graded the likelihood of a malignant obstruction, the overall image quality, and the visibility of ten, individual anatomic segments of both the biliary and pancreatic duct in each sequence. The area under the ROC curve and the repeated measures analyses of variance with multiple comparisons were used for the comparison. The κ statistics were used for interobserver agreement.ResultThe diagnostic performance for detecting malignancy was significantly higher on FB MRCP (A(z)=0.962) than on either BH SS-RARE (A(z)=0.820, P<0.0185) or MS-HASTE MRCP (A(z)=0.816, P<0.0067). Interobserver agreement was excellent for FB MRCP (κ=0.889) and fair for both BH SS-RARE (κ=0.578) and MS-HASTE MRCP (κ=0.49). FB MRCP had a significantly higher technical quality than BH MRCP (P<0.001). FB MRCP was seen to have statistically better visibility of peripheral IHD, right main IHD, CHD, cystic duct, and CBD than BH MRCP (P<0.001). FB MRCP and BH SS-RARE MRCP had statistically better visibility of both the left main IHD and pancreatic duct than did BH MS-HASTE MRCP (P<0.001).ConclusionFB 3D MRCP is useful for non-cooperative patients in whom conventional BH 2D methods cannot be used successfully.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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