MR imaging enhancement with superparamagnetic iron oxide in chronic liver disease: influence of liver dysfunction and parenchymal pathology.
OBJECTIVE
To analyze the influence of liver dysfunction and parenchymal pathology on the accumulation of superparamagnetic iron oxide (SPIO).


METHODS
We evaluated MR images of 13 patients having small hepatic neoplasms before and after administration of SPIO (10 micronol/kg). Biopsy and laboratory data confirmed the presence of severe cirrhosis in two patients, mild cirrhosis in four, chronic hepatitis in five, and normal livers in two. Degrees of liver dysfunction or liver parenchymal pathology were correlated with reductions in signal intensity of the liver and spleen after administration of SPIO. Signal intensity reduction was evaluated using a 1.5 Tesla MR unit.


RESULTS
Response to SPIO of the liver and spleen did not correlate with liver parenchymal pathology, although reductions in signal intensity of the liver were somewhat small in severely cirrhotic livers. There were slight correlations between signal intensity alterations of the liver and laboratory data such as the indocyanine green retention rate (correlation coefficient 0. 47), albumin (0.36), total bilirubin (0.36), and serum glutamic oxaloacetic transaminase (GOT) (0.46). Signal intensity reduction of spleen did not correlate with liver function tests except for serum GOT. In patients with cirrhosis, heterogeneous structures were detected in the nontumorous portions of the liver. However, these did not prevent the diagnosis of small hepatomas.


CONCLUSIONS
The uptake of SPIO showed some correlation with liver function but not with chronic liver parenchymal pathology. SPIO provided sufficient contrast between tumor and surrounding liver parenchyma among patients with chronic liver disease.
Yamashita
Y
Y
Department of Radiology, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860, Japan.
Yamamoto
H
H
Hirai
A
A
Yoshimatsu
S
S
Baba
Y
Y
Takahashi
M
M
D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D004396:Coloring Agents; D003287:Contrast Media; D005260:Female; D052203:Ferrosoferric Oxide; D006505:Hepatitis / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007089:Image Enhancement; D007208:Indocyanine Green; D007501:Iron; D008099:Liver / Q000473:pathology / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010087:Oxides; D012709:Serum Albumin / Q000032:analysis; D013154:Spleen / Q000473:pathology
D004396:Coloring Agents; D003287:Contrast Media; D010087:Oxides; D012709:Serum Albumin; D007501:Iron; D001219:Aspartate Aminotransferases; D007208:Indocyanine Green; D001663:Bilirubin; D052203:Ferrosoferric Oxide