MRI of focal nodular hyperplasia (FNH) with gadobenate dimeglumine (Gd-BOPTA) and SPIO (ferumoxides): an intra-individual comparison.

Abstract

PURPOSE:

To compare the efficacy of two different MR contrast agents for the detection and diagnosis of focal nodular hyperplasia (FNH).

MATERIALS AND METHODS:

Fifty patients with 83 FNH lesions detected on spiral CT were studied in two different MRI sessions with Gd-BOPTA (MultiHance) and ferumoxides (Endorem). MRI with Gd-BOPTA was performed precontrast (T1wGRE and T2wTSE sequences) and during the dynamic and late (1-3 hours) phases after injection (T1wGRE sequences only). MRI with ferumoxides (T1wGRE and T2wTSE sequences) was performed before and at least 30 minutes after injection. Hyper- or isointensity of FNH in the late phase was considered typical for Gd-BOPTA, while isointensity or lesion hypointensity was considered typical for ferumoxides.

RESULTS:

With Gd-BOPTA, 83 FNH lesions (100%) appeared hyperintense during the arterial phase of dynamic MRI. All but one lesion was iso- or slightly hyperintense in the portal-venous and equilibrium phases. In the late phase, 81 FNH lesions were hyper- or isointense to the surrounding parenchyma, with two lesions appearing slightly hypointense. With ferumoxides, a significant (P < 0.001) number (21/83, 25.3%) of FNH lesions (mean diameter = 16.8 +/- 6.6 mm) were not visible. Of the visible FNH lesions, 38/62 were slightly hyperintense, and 24/62 were isointense to the surrounding parenchyma on the T2wTSE images. On the T1wGRE images, 42/62 lesions were isointense, 19/62 were slightly hyperintense, and one lesion was slightly hypointense. Seventeen lesions in 12 patients with previous neoplasia were all detected after Gd-BOPTA administration, whereas only nine of these 17 lesions (52.9%) were detected after ferumoxide administration. Two of these nine lesions showed atypical enhancement features.

CONCLUSION:

Gd-BOPTA-enhanced MRI is significantly better than ferumoxide-enhanced MRI for the identification and characterization of FNH.

• Authors: Luigi Grazioli, Giovanni Morana, Miles A Kirchin, Paolo Caccia, Laura Romanini, Maria P Bondioni, Carlo Procacci, Antonio Chiesa
• Journal: Journal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 17 Issue 5 Pg. 593-602 (May 2003) ISSN: 1053-1807 [Print] United States
• PMID: 12720270 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
• Copyright: Copyright 2003 Wiley-Liss, Inc.

Chemical References

• Contrast Media
• Dextrans
• Magnetite Nanoparticles
• Organometallic Compounds
• Oxides
• gadobenic acid
• Meglumine
• Iron
• ferumoxides
• Ferrosoferric Oxide

Topics

• Adult
• Aged
• Contrast Media
• Dextrans
• Female
• Ferrosoferric Oxide
• Focal Nodular Hyperplasia (diagnosis)
• Humans
• Image Enhancement
• Iron
• Liver (pathology)
• Magnetic Resonance Imaging (methods)
• Magnetite Nanoparticles
• Male
• Meglumine (analogs & derivatives)
• Middle Aged
• Organometallic Compounds
• Oxides