Premium
Detection of focal hepatic lesions: Comparison of unenhanced and SHU 555 A‐enhanced MR imaging versus biphasic helical CTAP
Author(s) -
BaSsalamah Ahmed,
HeinzPeer Gertraud,
Schima Wolfgang,
Schibany Nadja,
Schick Susanne,
Prokesch Rupert W.,
Kaider Alexandra,
Teleky Bela,
Wrba Friedrich,
Lechner Gerhard
Publication year - 2000
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/1522-2586(200006)11:6<665::aid-jmri13>3.0.co;2-d
Subject(s) - medicine , magnetic resonance imaging , radiology , nuclear medicine , lesion , portography , ultrasound , biopsy , pathology , portal hypertension , cirrhosis
The purpose of this study was to compare the diagnostic sensitivity of unenhanced magnetic resonance (MR) imaging, and MR imaging with a new superparamagnetic iron oxide (SPIO)‐enhanced contrast agent (SHU 555 A) with biphasic helical computed tomography during arterial portography (CTAP) in patients with focal liver lesions. Eighteen patients with a total of 91 (78 malignant, 13 benign) proven liver lesions underwent unenhanced short tau inversion recovery (STIR), T2‐weighted (T2‐w) TSE, and SHU 555 A‐enhanced T2‐w turbo spin‐echo (TSE) MR imaging and biphasic helical CTAP. The standard of reference was histopathologic analysis of resected specimens in 59 lesions, intraoperative ultrasound with biopsy in 20 lesions, and CT‐guided biopsy and follow‐up in 12 lesions. Diagnostic performance of the imaging modalities was compared quantitatively and qualitatively by assessing lesion involvement in liver segments. There were 68 lesions detected on unenhanced T2‐w TSE, which resulted in a sensitivity of 75%. With the STIR sequence, 76 lesions were detected, for a sensitivity of 84%, and with SHU 555 A‐enhanced MRI, 84 lesions were detected, for a sensitivity of 92%. CTAP detected 88 lesions, for a sensitivity of 97%. The accuracy for unenhanced T2‐w TSE was 98%, for STIR 99%, for enhanced‐MRI 100%, and for CTAP 95%. The specificity was 100% for SHU 555 A‐enhanced MRI and 95% for CTAP. SHU 555 A‐enhanced MRI was superior to nonenhanced MRI ( P < 0.05) and equivalent to CTAP in terms of sensitivity. Due to the absence of false‐positive results on SHU 555 A‐enhanced MRI, the specificity and accuracy of enhanced MRI were higher than those of CTAP, but the difference was not statistically significant ( P = 0.134). J. Magn. Reson. Imaging 2000;11:665–672. © 2000 Wiley‐Liss, Inc.