title: Efficacy of sequential use of superparamagnetic iron oxide and gadolinium in liver MR imaging.
abstract: OBJECTIVE
  To evaluate the efficacy of combined (double contrast) use of superparamagnetic iron particles (SPIOs) and gadolinium (Gd) in liver MR imaging.
  
  
  METHODS
  Unenhanced, Gd-enhanced, SPIO-enhanced, and both SPIO- and Gd-enhanced images were acquired at 1.5 T. Twenty patients with previously detected liver lesions were included. Fast SE-STIR, and breath-hold true FISP, fat-suppressed T1- and T2-weighted sequences were obtained with all techniques. Lesion count was assessed by consensus reading.
  
  
  RESULTS
  Collective evaluation of all MR sequences revealed 61 lesions in 16 patients; SPIO-enhanced MR detected lesions with a sensitivity of 95% (n=58). The sensitivity of unenhanced MR imaging was 90% (n=55). There was no statistical difference between SPIO-enhanced and unenhanced MR images. From single sequences, the greatest number of lesions was detected with the SPIO-enhanced fast SE-STIR sequence (n=56, sensitivity 92%). By using the fat-suppressed T1-weighted sequence, Gd-enhanced and both SPIO- and Gd-enhanced MR images demonstrated sensitivities of 77% (n=47) and 80% (n=49), respectively. Despite the combined use of both contrast media, this sequence was significantly less sensitive in lesion detection when compared to SPIO-enhanced imaging.
  
  
  CONCLUSIONS
  SPIO-enhanced MR imaging was the most sensitive method in lesion detection. The benefit of the combined use of SPIO and Gd was negligible.
authors: Department of Radiology, Helsinki University Central Hospital, Finland.
authors: J
authors: J
authors: Halavaara
authors: P
authors: P
authors: Tervahartiala
authors: H
authors: H
authors: Isoniemi
authors: K
authors: K
authors: Höckerstedt
mesh_terms: D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D005682:Gadolinium; D006801:Humans; D007501:Iron; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D012680:Sensitivity and Specificity
chemical_list: D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D005682:Gadolinium; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide