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Ultrahigh-Field Imaging of the Biliary Tract at 7 T: Initial Results of Gadoxetic Acid–Enhanced Magnetic Resonance Cholangiography

Fischer, Anja MD*†; Kraff, Oliver PhD*†; Orzada, Stephan PhD*†; Nensa, Felix MD*; Schäfer, Lena C.*†; Ladd, Mark E. PhD*†; Umutlu, Lale MD*†; Lauenstein, Thomas C. MD*

doi: 10.1097/RLI.0000000000000004
Original Articles

Objectives The objectives of this study were to assess the feasibility of magnetic resonance cholangiography (MRC) using biliary-secreted gadoxetic acid at 7 T and to compare it with T2-weighted (w) MRC at 3 T.

Materials and Methods Ten healthy volunteers were examined on a 7-T whole-body magnetic resonance system. T2-weighted turbo-spin-echo sequence, T1-w volume-interpolated breath-hold examination (VIBE), and fast low-angle shot (FLASH) with inversion recovery (IR) were acquired in coronal orientation. For dynamic imaging, gadoxetic acid was administrated and data were collected for a period of 5 to 40 minutes after injection. The volunteers underwent subsequent T2-w respiratory-gated MRC at 3 T. For qualitative analysis, a 5-point scale was used. Contrast ratios (CRs) were calculated for quantitative assessment.

Results Contrast-enhanced T1-w MRC at 7 T showed a homogeneous depiction of the intrahepatic and extrahepatic biliary tract with a maximum enhancement of 20 minutes after contrast. Volume-interpolated breath-hold examination and FLASH IR provided a good image quality for the intrahepatic (VIBE, 3.60; FLASH IR, 3.67) and extrahepatic bile ducts (VIBE, 3.50; FLASH IR, 3.72). The quantitative analysis revealed high CR values for FLASH IR (intrahepatic CR, 0.41; extrahepatic CR, 0.45) because of an effective suppression of hepatic tissue and vessels. The T2-w TSE at 7 T showed only a poor image quality without diagnostic potential (intrahepatic, 2.22; extrahepatic, 1.93). Seven-tesla VIBE and FLASH revealed superiority in the depiction of the intrahepatic bile ducts, whereas 3-T MRC was superior in the delineation of the extrahepatic biliary tract.

Conclusions Our results demonstrate the feasibility of contrast-enhanced imaging of the biliary ducts at 7 T.

From the *Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen; and †Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.

Received for publication March 20, 2013; and accepted for publication, after revision, August 23, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Anja Fischer, MD, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany. E-mail:

© 2014 by Lippincott Williams & Wilkins