To compare two magnetic resonance cholangiopancreatography (MRCP) sequences at 3 Tesla (3T): the conventional 3D Respiratory-Triggered SPACE sequence (RT-MRCP) and a prototype 3D Compressed-Sensing Breath-Hold SPACE sequence (CS-BH-MRCP), in terms of qualitative and quantitative image quality and radiologist’s diagnostic confidence for detecting common bile duct (CBD) lithiasis, biliary anastomosis stenosis in liver-transplant recipients, and communication of pancreatic cyst with the main pancreatic duct (MPD). Sixty-eight patients with suspicion of choledocholithiasis or biliary anastomosis stenosis after liver transplant, or branch-duct intraductal papillary mucinous neoplasm of the pancreas (BD-IPMN), were included. The relative CBD to peri-biliary tissues (PBT) contrast ratio (CR) was assessed. Overall image quality, presence of artefacts, background noise suppression and the visualization of 12 separated segments of the pancreatic and bile ducts were evaluated by two observers working independently on a five-point scale. Diagnostic confidence was scored on a 1–3 scale. The CS-BH-MRCP presented significantly better CRs (p < 0.0001), image quality (p = 0.004), background noise suppression (p = 0.011), fewer artefacts (p = 0.004) and better visualization of pancreatic and bile ducts segments with the exception of the proximal CBD (p = 0.054), cystic duct confluence (p = 0.459), the four secondary intrahepatic bile ducts, and central part of the MPD (p = 0.885) for which no significant differences were found. Overall, diagnostic confidence was significantly better with the CS-BH-MRCP sequence for both readers (p = 0.038 and p = 0.038, respectively). This study shows that the CS-BH-MRCP sequence presents overall better image quality and bile and pancreatic ducts visualization compared to the conventional RT-MRCP sequence at 3T.

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