ABSTRACT
PURPOSE: To assess the safety and diagnostic efficacy of intravenous ferumoxides, a superparamagnetic iron oxide, for depiction of focal hepatic lesions on magnetic resonance (MR) images. MATERIALS AND METHODS: This open-label study included 208 patients with known or suspected focal hepatic lesions. MR images were obtained before and 45 minutes to 4 hours after intravenous infusion of ferumoxides (10 mumol/kg). The effect of ferumoxides on signal intensity of the liver was assessed with quantitative analysis. Safety was evaluated with patient monitoring and laboratory measurements. RESULTS: Mean lesion-to-liver contrast-to-noise ratio on T2-weighted images was 9.1 on unenhanced images and 12.7 on enhanced images. Signal intensity of normal liver on enhanced images decreased to 37% of that on unenhanced images. In blinded image evaluations, additional lesions were identified on 27% of enhanced images. No serious adverse events occurred. CONCLUSION: Ferumoxides is a safe and efficacious contrast agent for the detection of focal liver lesions on T2-weighted images.
Subject(s)
Contrast Media , Iron , Liver Diseases/diagnosis , Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Liver/pathology , Oxides , Contrast Media/adverse effects , Dextrans , Female , Ferrosoferric Oxide , Humans , Image Processing, Computer-Assisted , Iron/adverse effects , Liver/diagnostic imaging , Magnetite Nanoparticles , Male , Middle Aged , Oxides/adverse effects , Time Factors , Tomography, X-Ray ComputedABSTRACT
Magnetic resonance (MR) imaging has revolutionized the assessment of pathology involving the musculoskeletal system. The soft tissue contrast, superb resolution, multiplanar acquisition potential, and the ability to monitor physiologic processes combine the best features of other imaging modalities. The sensitivity and specificity of MR imaging for a wide range of disease processes matches or supersedes conventional radiology, nuclear medicine, and clinical examination. This article provides a brief overview of the use of MR imaging for some of the more common clinical situations confronting the rheumatologist.
Subject(s)
Magnetic Resonance Imaging , Rheumatic Diseases/diagnosis , Diagnosis, Differential , HumansABSTRACT
PURPOSE: To measure apparent diffusion coefficients (ADCs) of water in liver, spleen, kidney, and muscle. MATERIALS AND METHODS: Ten volunteers (seven women and three men, aged 19-31 years [mean, 24 years]) and nine patients (five women and four men, aged 49-70 years [mean, 62 years]) (liver cyst, n = 3; liver hemangioma, n = 3; liver cirrhosis, n = 2; hepatocellular carcinoma, n = 1; and liver metastasis, n = 1) underwent magnetic resonance (MR) imaging. A stimulated-echo acquisition mode (STEAM)-type excitation and echo-planar imaging (EPI) readout was used in a 1.5-T echo-planar MR imaging system. RESULTS: ADCs measured in volunteers were liver, 1.39 x 10(-3) mm2/sec +/- 0.16; spleen, 0.95 x 10(-3) mm2/sec +/- 0.15; muscle, 1.99 x 10(-3) mm2/sec +/- 0.16; and kidney, 3.54 x 10(-3) mm2/sec +/- 0.47 (mean +/- standard deviation). Distinctive ADC values were found in organs with abnormalities. ADCs in patients with hepatic disease included liver cysts, 3.9-5.3; liver hemangiomas, 2.0-2.8; liver metastases from an islet cell tumor, 1.2; hepatocellular carcinoma, 1.7; and liver cirrhosis, 0.9-1.2 x 10(-3) mm2/sec. CONCLUSION: In vivo diffusion measurements of abdominal organs obtained with MR imaging may prove helpful in the identification and classification of abdominal disease.
Subject(s)
Abdomen/anatomy & histology , Echo-Planar Imaging , Abdomen/pathology , Adult , Aged , Echo-Planar Imaging/methods , Female , Humans , Liver Diseases/diagnosis , Male , Middle Aged , Models, StructuralABSTRACT
The authors studied the utility of non-contrast-agent-enhanced magnetic resonance (MR) imaging for differentiating cysts and cavernous hemangiomas of the liver. Nineteen patients with hemangiomas (51 lesions) and 16 with cysts (30 lesions) were studied with a 1.5-T MR imager. T2 values were calculated with the two-point method to evaluate the efficacy of T2 values in the differentiation between hemangiomas and cysts of the liver. For lesions larger than 1 cm, the mean T2 value of cysts (306 msec +/- 156) was significantly longer than that of hemangiomas (113 msec +/- 15) (P < .0001); there was no overlap of the ranges for T2 values of hemangiomas and cysts. All cysts larger than 1 cm could be differentiated from hemangiomas by using a threshold T2 value of 140 msec. This study suggests that calculated T2 values permit differentiation between hemangiomas and cysts larger than 1 cm at 1.5 T.
