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Free-breathing Three-dimensional MR Cholangiopancreatography Using Centric k-space Encoding Improved Gallbladder

Junya Tsuzaki¹, Taiki Nozaki^1,2, Daiki Ito^3,4

¹Department of Radiology, Keio University School of Medicine, Tokyo, Japan.

Magnetic Resonance in Medical Sciences : MRMS : an Official Journal of Japan Society of Magnetic Resonance in Medicine

|February 8, 2026

Summary

MRCP-CORE, a new free-breathing MRI technique, significantly improves gallbladder visualization compared to conventional MRCP. This novel method offers a robust alternative to breath-hold techniques for enhanced diagnostic imaging.

Keywords:

biliary imaging concentrated bile gallbladder k-space trajectory magnetic resonance cholangiopancreatography

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Area of Science:

Radiology and Medical Imaging
Gastroenterology
Biomedical Engineering

Background:

Magnetic Resonance Cholangiopancreatography (MRCP) can be limited by signal loss due to concentrated bile.
Gradient-and-spin-echo (GRASE) MRCP improves signal but requires breath-holding.
Developing free-breathing MRCP techniques is crucial for patient comfort and image quality.

Purpose of the Study:

To develop and evaluate MRCP with centric order encoding (MRCP-CORE), a novel free-breathing sequence.
To assess MRCP-CORE's ability to visualize the gallbladder compared to conventional and GRASE MRCP.
To investigate the impact of bile concentration on gallbladder visibility across different MRCP sequences.

Main Methods:

Prospective study of 100 patients undergoing three MRCP sequences (MRCP-CORE, conventional MRCP, GRASE MRCP) on a 3T system.
Independent radiologist assessment of anatomical structure visibility, artifacts, and overall image quality.
Quantitative measurement of SNR, contrast-to-noise ratio, and contrast ratio; statistical analysis using Friedman and Jonckheere-Terpstra tests.

Main Results:

MRCP-CORE demonstrated significantly higher Signal-to-Noise Ratio (SNR) compared to conventional and GRASE MRCP (20.9 vs. 17.3 vs. 15.8; P < 0.001).
Gallbladder visibility was significantly improved with MRCP-CORE versus conventional MRCP (P = 0.02), comparable to GRASE MRCP (P = 1.00).
Bile concentration impacted gallbladder visibility in conventional MRCP (P < 0.001) but not in MRCP-CORE (P = 0.12) or GRASE MRCP (P = 0.43).

Conclusions:

MRCP-CORE enhances gallbladder depiction compared to conventional MRCP.
MRCP-CORE provides a robust free-breathing alternative to breath-hold GRASE MRCP.
The novel sequence overcomes limitations associated with bile concentration in MRCP.