title: Characterization of focal liver lesions with superparamagnetic iron oxide-enhanced MR imaging: value of distributional phase T1-weighted imaging.
abstract: OBJECTIVE
  To determine the potential value of distributional-phase T1-weighted ferumoxides-enhanced magnetic resonance (MR) imaging for tissue characterization of focal liver lesions.
  
  
  METHODS
  Ferumoxides-enhanced MR imaging was performed using a 1.5-T system in 46 patients referred for evaluation of known or suspected hepatic malignancies. Seventy-three focal liver lesions (30 hepatocellular carcinomas (HCC), 12 metastases, 15 cysts, 13 hemangiomas, and three cholangiocarcinomas) were evaluated. MR imaging included T1-weighted double-echo gradient-echo (TR/TE: 150/4.2 and 2.1 msec), T2*-weighted gradient-echo (TR/TE: 180/12 msec), and T2-weighted turbo spin-echo MR imaging at 1.5 T before and after intravenous administration of ferumoxides (15 mmol/kg body weight). Postcontrast T1-weighted imaging was performed within eight minutes of infusion of the contrast medium (distributional phase). Both qualitative and quantitative analysis was performed.
  
  
  RESULTS
  During the distributional phase after infusion of ferumoxides, unique enhancement patterns of focal liver lesions were observed for hemangiomas, metastases, and hepatocellular carcinomas. On T1-weighted GRE images obtained during the distributional phase, hemangiomas showed a typical positive enhancement pattern of increased signal; metastases showed ring enhancement; and hepatocellar carcinomas showed slight enhancement. Quantitatively, the signal-to-noise ratio of hemangiomas was much higher than that of other tumors (p <.05) and was similar to that of intrahepatic vessels. This finding permitted more effective differentiation between hemangiomas and other malignant tumors.
  
  
  CONCLUSIONS
  T1-weighted double-echo FLASH images obtained soon after the infusion of ferumoxides, show characteristic enhancement patterns and improved the differentiation of focal liver lesions.
authors.affiliation: Department of Diagnostic Radiology, Seoul National University Hospital, Korea. leejm@radcom.snu.ac.kr
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Chong Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Youk
authors.forename: Mi Suk
authors.initials: MS
authors.lastname: Lee
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003560:Cysts / Q000175:diagnosis; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D007501:Iron; D008107:Liver Diseases / Q000175:diagnosis; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D013535:Suspensions
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D013535:Suspensions; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide