Background: The detection and characterization of liver lesions are problematic in patients with bronchial asthma, renal dysfunction, or a history of allergy to gadolinium-based magnetic resonance contrast media or iodine-computed tomography contrast media because these contrast media cannot be used. Hence, the information on the lesion vascularity cannot be obtained. Therefore, this retrospective case-control study evaluated the feasibility of superparamagnetic iron oxide (SPIO) in patients with one or more of these contraindications who underwent SPIO-enhanced magnetic resonance imaging for the assessment of liver lesions.Methods: Twenty-six patients with a total of 48 lesions were analyzed. SPIO was used in the case of all patients because each patient had at least one reason not to use iodine contrast or gadolinium-based contrast media. Additionally, all patients were subjected to the perfusion study. A total volume of 1.3 mL of SPIO was injected via the cubital vein at a rate of 3 mL per second, followed by 40 mL saline at the same speed. The scanning of the perfusion study was started 4 s after the beginning of superparamagnetic iron oxide injection and scanning took 50 s. Two radiologists independently evaluated whether the lesion was malignant or benign. Receiver operating characteristic analysis (ROC) was performed to determine the additional benefit of the perfusion study.Results: There were no adverse effects associated with SPIO. The area under the curve (AUC) value without perfusion study for observers 1 and 2 were 0.473 (P=0.794, 95% CI: 0.275-0.672) and 0.602 (P=0.305, 95% CI: 0.407-0.798), respectively, whereas the Az values with perfusion study for observers 1 and 2 were 0.782 (P=0.011, 95% CI: 0.565-0.998) and 0.784 (P=0.004, 95% CI: 0.591-0.977), respectively.Az value became significantly better when the perfusion study has added (P=0.001 and 0.012 by observers 1 and 2).Conclusions: SPIO can be used safely in patients with bronchial asthma, renal dysfunction, or a history of contrast media allergy. Furthermore, the diagnostic accuracy of SPIO was acceptable.
Objectives:: To evaluate the differences in contrast enhancement of abdominal organ on abdominal dynamic MRI using 0.1 mmol/kg 1.0M gadobutrol (GAD) versus 0.5M meglumine gadoterate (MG) in patients having liver hemangioma. Materials and methods:: Phantom study was performed with different concentration (0.05, 0.1, 0.3, 0.5, 0.7, 0.9, 1.0, 5.0 and 10 mmol/L) of GAD and MG. Sixty-two patients with liver hemangioma were enrolled. Contrast media were injected a rate of 2mL/s and the 40mL of saline followed. Monitoring scan was used for acquiring arterial phase. Two arterial phases, portal and equilibrium phase were obtained. One certified radiologist set region of interests on abdominal aorta, liver, pancreas, spleen, liver hemangioma. The relative enhancement ratio (RER) was calculated. Results:: In phantom study, the signal intensity of both contrast media was similar in lower concentration, however, signal intensity of MG was higher in more than 5.0 mmol/L. In clinical study, the RER of abdominal viscera on portal and equilibrium phase were higher in GAD. Hemangioma showed higher on equilibrium phase in GAD. The aortic RER did not show significant difference in all phases and liver RER on 2nd arterial phase showed much higher in GAD. Arterial phase in GAD might have been late for optimal timing. Conclusions:: When same injection protocol used for abdominal dynamic MRI, arterial phase became late in case of using GAD. The higher T1 relaxivity value showed significant higher enhancement in abdominal viscera on portal phase and equilibrium phase and hemangioma showed also significant higher enhancement on equilibrium phase.
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