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Focal nodular hyperplasia of the liver on ferumoxides-enhanced MR imaging: features on conventional spin-echo, fast
S Precetti-Morel1, M F Bellin, L Ghebontni
1Department of Radiology, Pitié-Salpétrière Hospital, University Paris VI, 83 Boulevard de l'Hôpital, F-75651 Paris Cedex 13, France.
Abstract:
The aim of this study was to assess the efficacy of a superparamagnetic iron oxide, ferumoxides, in the detection and characterization of focal nodular hyperplasia (FNH) on MR conventional spin-echo (SE), fast spin-echo (FSE) and gradient-echo (GRE) images. Fourteen adults with 27 FNHs were evaluated at 1.5 T before and after injection of ferumoxides. T1-weighted and T2-weighted SE, T2-weighted FSE and T2(*)-weighted GRE sequences were used and analysed qualitatively and quantitatively. One hundred percent of FNHs showed a significant postcontrast decrease in signal intensity on T2- and T2*-weighted images. Heavily T2-weighted SE images showed the maximum decrease in FNH signal-to-noise ratio (S/N). Postcontrast GRE T2(*)-weighted images improved the detection of the central scar and the delineation of FNHs and demonstrated the best lesion-to-liver contrast-to-noise ratio (C/N). Postcontrast T1-weighted SE images showed the least lesion-to-liver C/N. Ferumoxides-enhanced MR imaging can help detect and characterize FNH. Conventional pre- and postcontrast T2-weighted SE images and postcontrast GRE T2*-weighted images should be used preferentially.
Insights
Ferumoxides, a superparamagnetic iron oxide contrast agent, effectively detects and characterizes focal nodular hyperplasia (FNH) in MRI scans. Utilizing specific MRI sequences like T2-weighted SE and T2*-weighted GRE enhances FNH visualization and differentiation.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Focal nodular hyperplasia (FNH) is a common benign liver tumor.
- Accurate detection and characterization of FNH are crucial for appropriate patient management.
- Superparamagnetic iron oxides offer unique contrast properties for MRI.
Purpose of the Study:
- To evaluate the efficacy of ferumoxides in detecting and characterizing FNH using various MRI sequences.
- To compare the performance of conventional spin-echo (SE), fast spin-echo (FSE), and gradient-echo (GRE) imaging after ferumoxides administration.
- To determine optimal MRI sequences for FNH assessment with ferumoxides.
Main Methods:
- A study involving 14 adult patients with 27 FNHs evaluated using 1.5 T MRI.
- Ferumoxides contrast agent administered intravenously before and after imaging.
- Utilized T1-weighted SE, T2-weighted SE, T2-weighted FSE, and T2(*)-weighted GRE sequences.
- Qualitative and quantitative image analysis including signal-to-noise ratio (S/N) and contrast-to-noise ratio (C/N).
Main Results:
- 100% of FNHs demonstrated a significant postcontrast signal intensity decrease on T2- and T2*-weighted images.
- Heavily T2-weighted SE images yielded the maximum reduction in FNH signal-to-noise ratio (S/N).
- Postcontrast GRE T2*-weighted images enhanced central scar detection, FNH delineation, and lesion-to-liver contrast-to-noise ratio (C/N).
- Postcontrast T1-weighted SE images showed the lowest lesion-to-liver C/N.
Conclusions:
- Ferumoxides-enhanced MRI is valuable for detecting and characterizing FNH.
- Preferential use of conventional pre- and postcontrast T2-weighted SE images and postcontrast GRE T2*-weighted images is recommended.
- This approach improves diagnostic accuracy for FNH compared to standard MRI techniques.