title: Differentiation of liver hemangiomas from metastases and hepatocellular carcinoma at MR imaging enhanced with blood-pool contrast agent Code-7227.
abstract: OBJECTIVE
  To evaluate differentiation of liver lesions at magnetic resonance (MR) imaging enhanced with Code-7227.
  
  
  METHODS
  Thirty-five patients with 38 proved liver lesions (15 hemangiomas, 17 metastases, six hepatocellular carcinomas [HCCs]) underwent T1-weighted gradient-echo and T2-weighted fast-spin-echo MR imaging at 1.5 T before and after intravenous administration of Code-7227 (1.1 mg iron per kilogram of body weight).
  
  
  RESULTS
  In hemangiomas, the mean contrast-to-noise ratio on precontrast and postcontrast images, respectively, increased from -4.51 +/- 4.7 (standard deviation) to 5.19 +/- 6.3 on T1-weighted images and decreased from 14.73 +/- 7.4 to 0.64 +/- 5.1 on T2-weighted images. In comparison, metastases remained hypointense to liver on T1-weighted images (from -5.77 +/- 5.9 to -7.8 +/- 6.8) and hyperintense on T2-weighted images (from 8.73 +/- 5.4 to 12.61 +/- 6.1). Although HCC enhanced more than metastases, they also remained hypointense to liver on T1-weighted images (from -4.87 +/- 6.1 to -1.79 +/- 5.7) and hyperintense on T2-weighted images (from 10.12 +/- 7.9 to 8.7 +/- 6.4). The degree of enhancement on T1-weighted images and of signal intensity drop on T2-weighted images were significantly lower in malignant liver masses than in hemangiomas (P < .001).
  
  
  CONCLUSIONS
  Distinctly different enhancement patterns with Code-7227 helped accurate differentiation of liver lesions.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114 USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Harisinghani
authors.forename: S
authors.initials: S
authors.lastname: Saini
authors.forename: R
authors.initials: R
authors.lastname: Weissleder
authors.forename: E F
authors.initials: EF
authors.lastname: Halpern
authors.forename: W
authors.initials: W
authors.lastname: Schima
authors.forename: D L
authors.initials: DL
authors.lastname: Rubin
authors.forename: A E
authors.initials: AE
authors.lastname: Stillman
authors.forename: G T
authors.initials: GT
authors.lastname: Sica
authors.forename: W C
authors.initials: WC
authors.lastname: Small
authors.forename: P F
authors.initials: PF
authors.lastname: Hahn
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003911:Dextrans; D003937:Diagnosis, Differential; D005260:Female; D052203:Ferrosoferric Oxide; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; C097921:ferumoxtran-10; D007501:Iron; D052203:Ferrosoferric Oxide