[Comparison of dual-phase helical CT with native and ferum oxide-enhanced magnetic resonance imaging in detection and characterization of focal liver lesions].
OBJECTIVE
Evaluation of the diagnostic efficacy of contrast-enhanced, dual-phase spiral CT and MRI before and after administration of SPIO particles in focal hepatic disease with previously uncertain diagnosis.


METHODS
In 46 patients in whom primary or secondary hepatic malignancy was suspected, dual-phase spiral CECT and breath-held T1-weighted gradient-echo and T2-weighted fast spin-echo MRI (1.5 T, body-phased-array coil) before and after SPIO administration were compared. The indications for the subsequent MRI studies were based on ambiguous findings on CECT. The number of hepatic lesions, the overall lesion detection and characterization was evaluated by consensus and compared to the gold standard (histological proof in 30/46 of the cases, long-term follow-up in 16/46 of the cases).


RESULTS
In 34 of 46 cases the correct diagnoses were established by CECT (sensitivity 96%, specificity 48%) revealing significantly less lesions than MRI. Unenhanced MRI had sensitivity of 93% and specificity of 71%, whereas SPIO-enhanced MRI had sensitivity of 97% and specificity of 88%. The differences between the modalities were even more pronounced in the detection of lesions smaller than 10 mm with SPIO-MRI as the most sensitive method.


CONCLUSIONS
In this problem-oriented scenario, SPIO-enhanced MRI was superior to spiral CT and unenhanced MRI regarding the diagnostic efficacy in the pre-operative work-up of focal liver lesions. SPIO-enhanced MRI can be recommended as a problem-solving tool for the clinical routine.
Helmberger
T
T
Institut für Radiologische Diagnostik, Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Gregor
M
M
Holzknecht
N
N
Gauger
J
J
Rau
H
H
Reiser
M F
MF
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D003287:Contrast Media