[Differential diagnosis of intra- and perilienal tumors by use of a RES-specific MRI contrast agent].
OBJECTIVE
To describe the additional benefit in detection and differential diagnosis of peri- and intrasplenic tumors by use of an superparamagnetic iron oxide contrast agent (SPIO).


METHODS
We represent 7 patients with known malignant tumors. Aim of the examination was the detection and characterisation of intra- or perisplenic tumors. We performed T2w TSE breath triggered sequences before and 10 min after application of SPIO and T1w Flash 2D GRE sequences before and after SPIO and Gadopentetate dimeglumin application. All images were presented to two radiologists, who were asked to asses the presence and characterisation of tumors by using a five-point confidence scale.


RESULTS
In two patient intrasplenic hemangiomas were detected, intrasplenic lymphoma, metastasis was excluded, respectively. In two patients perisplenic tumors were diagnosed as gastrointestinal stroma tumors, confirmed by biopsy. In two patients accessory spleens were identified and lymph node metastasis excluded. In one patient an intrasplenic cyst was diagnosed. SPIO enhanced T2w images and Gadopentetate dimeglumin enhanced T1w sequences were evaluated as superior.


CONCLUSIONS
The examination of the spleen by use of superparamagnetic iron oxides offers additional abilities in depiction and charaterisation of intra- and perisplenic tumors in first experiences. First clinical observations indicate that a combination of SPIO enhanced T2w sequences and Gadopentetate dimeglumin enhanced T1w dynamic sequences might be superior to other sequences in detection and characterisation of splenic tumors.
Gaffke
Gunnar
G
Klinik und Poliklinik für Strahlenheilkunde der Charité, CampusVirchow Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin. gunnar.gaffke@charite.de
Stroszczynski
Christian
C
Gnauck
Manuela
M
Jost
Dominik
D
Chmelik
Petra
P
Ludwig
Wolf-Dieter
WD
Gretschel
Stefan
S
Felix
Roland
R
D000328:Adult; D000368:Aged; D003287:Contrast Media; D003911:Dextrans; D003937:Diagnosis, Differential; D005260:Female; D005290:Ferric Compounds; D052203:Ferrosoferric Oxide; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D012157:Mononuclear Phagocyte System / Q000473:pathology*; D010087:Oxides; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology; D013160:Splenic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary
D003287:Contrast Media; D003911:Dextrans; D005290:Ferric Compounds; D058185:Magnetite Nanoparticles; D010087:Oxides; C427127:superparamagnetic blood pool agent; D007501:Iron; C065507:ferumoxides; D019786:Gadolinium DTPA; D052203:Ferrosoferric Oxide