[Differential diagnosis of intra- and perilienal tumors by use of a RES-specific MRI contrast agent]. / Differenzialdiagnose von Intra- und Perilienalen Tumoren mit Hilfe eines RES-spezifischen MRT-Kontrastmittels.

PURPOSE: 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). MATERIALS AND 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. CONCLUSION: 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.