GRASE Revisited: breath-hold three-dimensional (3D) magnetic resonance cholangiopancreatography using a Gradient and Spin Echo (GRASE) technique at 3T.

OBJECTIVE: To evaluate the clinical feasibility and image quality of breath-hold (BH) three-dimensional (3D) magnetic resonance cholangiopancreatography (MRCP) using a gradient and spin-echo (GRASE) technique compared to the conventional 3D respiratory-triggered (RT)-MRCP using a turbo spin-echo (TSE) sequence at 3 T. METHODS: Sixty-six patients underwent both 3D RT-TSE-MRCP and 3D BH-GRASE-MRCP at 3 T. Three radiologists independently reviewed the visualisation of biliary and pancreatic ducts, image blurring, and overall image quality of the two data sets using four- or five-point scales. The numbers of scans with non-diagnostic or poor image quality were compared between the two scans. RESULTS: The 3D BH-GRASE-MRCP had a significantly better image quality (3.69 ± 0.77 vs. 3.30 ± 1.18, p = 0.005) and less image blurring (3.23 ± 0.94 vs. 3.65 ± 0.57, p = 0.0003) than the 3D RT-TSE-MRCP. In detail, 3D BH-GRASE-MRCP better depicted the common bile duct, cystic duct, and bilateral first intrahepatic duct (all ps < 0.05). The number of scans with non-diagnostic or poor image quality significantly decreased with 3D BH-GRASE-MRCP compared with 3D RT-TSE-MRCP [19.7% (13/66) vs. 1.5% (1/66), p = 0.002]. CONCLUSION: The 3D BH-GRASE-MRCP provided better image quality and a reduced number of non-diagnostic images compared to 3D RT-TSE-MRCP. KEY POINTS: • The GRASE technique enabled 3D MRCP acquisition within a single breath-hold. • The short acquisition time of 3D BH-GRASE-MRCP significantly reduced image blurring. • The 3D BH-GRASE-MRCP had a better image quality than 3D RT-TSE-MRCP. • The number of non-diagnostic scans was reduced with 3D BH-GRASE-MRCP.