Comparison of contrast enhanced CT and Mn-DPDP enhanced MRI for detection of focal hepatic lesions. Initial findings.
Twenty-nine patients with known or suspected focal hepatic disease were evaluated in a retrospective multi-institutional study comparing T1-weighted manganese (II) N,N'-dipyridoxylethylenediamine-N,N'-diacetate 5,5'-bis (phosphate) (DPDP) enhanced magnetic resonance imaging (MRI) with dynamic sequential bolus contrast enhanced computed tomography (DBCT) for the detection of focal liver lesions. The patients were divided into four dose groups, receiving 3, 5, 8, or 10 mumol/kg of Mn-DPDP, delivered either via intravenous bolus (0.25 ml/sec) or infusion (1 ml/sec). Each of three readers, with varying levels of expertise in interpreting hepatic MRI and CT studies, identified more lesions on the Mn-DPDP enhanced MRI than the contrast enhanced CT images. Mn-DPDP enhanced MRI depicted the presence of extensive metastatic disease not seen with DBCT in three patients with fatty liver. The most experienced MRI reader saw more lesions per patient on the Mn-DPDP enhanced MRI than with DBCT, while the opposite held true for the most experienced CT reader. The best single exam for detection of hepatic lesions may be determined by the experience of the reader.
Birnbaum
B A
BA
Department of Radiology, New York University Medical Center, New York 10016.
Weinreb
J C
JC
Fernandez
M P
MP
Brown
J J
JJ
Rofsky
N M
NM
Young
S W
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003560:Cysts / Q000175:diagnosis / Q000000981:diagnostic imaging; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005234:Fatty Liver / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008107:Liver Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008345:Manganese; D008875:Middle Aged; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D008345:Manganese; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid