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Vergleich von 2D- und 3D-Sequenzen für die MRCP

Klinischer Stellenwert der einzelnen Techniken

Comparison of 2D and 3D sequences for MRCP

Clinical value of the different techniques

  • Gallenwege — Diagnostik und interventionelle Therapie
  • Published:
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Zusammenfassung

Die Magnetresonanzcholangiopankreatikographie (MRCP) ist eine nichtinvasive Untersuchungsmethode des pankreatikobiliären Systems, die heute einen festen Platz in der klinischen Diagnostik eingenommen hat. Die vorliegende Arbeit gibt einen Überblick über die derzeit gängigen Sequenzen, ihre technischen Grundlagen sowie ihre jeweilige Bedeutung in den verschiedenen klinischen Einsatzgebieten und Fragestellungen. Darüber hinaus werden die Bedeutung der parallelen Bildgebung, der navigatorbasierten Atemtriggerung und der neu eingeführten dreidimensionalen Sequenzen für die MRCP sowie ihre möglichen Einsatzgebiete behandelt. Für die MRCP haben die 3 gängigen Sequenzen, die SS-RARE-Sequenz, die T2w-single-shot-fast-spin-echo- (SSFSE) und die 3D-FSE-Sequenz spezifische Vor- und Nachteile. Die SS-RARE-Sequenz ist aufgrund der sehr kurzen Messzeit bei schwerkranken Patienten einsetzbar. Bei der Differenzierung von benignen zu malignen Stenosen hat die SSFSE eine große Bedeutung. Die 3D-FSE-Sequenz bringt einen signifikanten Zugewinn bei der Detektion von Konkrementen.

Abstract

Magnetic resonance cholangio-pancreaticograpy (MRCP) is a non-invasive imaging modality of the pancreatico-biliary system which plays an increasingly important role in the clinical and diagnostic workup of patients with biliary or pancreatic diseases. The present review is designed to give an overview of the currently available and appropriate sequences, their technical background, as well as new developments and their relevance to the various clinical issues and challenges. The impact of the latest technical innovations, such as integrated parallel imaging techniques and navigator-based respiratory triggering, on the diagnostic capacities of MRCP is discussed. In this context, the individual value of RARE, T2w single shot turbo/fast spin echo (SSFSE) and the recently introduced 3D T2w turbo/fast spin echo sequences (T2w 3D-T/FSE) is reviewed. RARE imaging may be preferred in severely ill patients with limitations in cooperation, SSFSE is particularly effective in differentiating benign and malignant stenosis, and 3D-FSE offers additional advantages in the detection of small biliary concrements.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum Großhadern der Ludwig-Maximilian-Universität München

    A. M. Wallnoefer, K. A. Herrmann, C. J. Zech, S. Gourtsoyianni, M. F. Reiser & S. O. Schoenberg

  2. Klinik für Innere Medizin II, Klinikum Großhadern der Ludwig-Maximilian-Universität München

    U. Beuers

  3. Institut für Klinische Radiologie, Klinikum Großhadern der Ludwig-Maximilian-Universität München, Marchioninistraße 15, 81377, München

    A. M. Wallnoefer

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  1. A. M. Wallnoefer
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  2. K. A. Herrmann
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  3. U. Beuers
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  4. C. J. Zech
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  5. S. Gourtsoyianni
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  6. M. F. Reiser
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  7. S. O. Schoenberg
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Correspondence to A. M. Wallnoefer.

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Wallnoefer, A.M., Herrmann, K.A., Beuers, U. et al. Vergleich von 2D- und 3D-Sequenzen für die MRCP. Radiologe 45, 993–1003 (2005). https://doi.org/10.1007/s00117-005-1283-1

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  • DOI: https://doi.org/10.1007/s00117-005-1283-1

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