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MnDPDP as a negative hepatic contrast agent: evaluation of STIR imaging compared with T1-weighted SE and GE
1Department of Radiology, Helsinki University Central Hospital, Finland.
Abstract:
Our goal was to assess the utility of manganese dipyridoxyl diphosphate (MnDPDP) as a negative hepatic contrast agent in short inversion time IR MRI (STIR). Twenty patients with focal liver lesions (15 with metastatic disease, 5 with hemangiomas) underwent MRI (T1-weighted SE, breath-hold GE, and STIR sequences) before and after infusion of MnDPDP (5 mumol/kg). We then compared the results obtained with each sequence for hepatic parenchymal enhancement, lesion-to-liver contrast-to-noise ratio (C/N) measurements, and the number of focal liver lesions observed in pre- and postcontrast images. Hepatic enhancement values of 25.3 +/- 9.7 and 33.6 +/- 2.7% (mean +/- SEM) were obtained for the T1-weighted SE and GE sequences, respectively. The STIR sequence showed 78.9 +/- 2.1% negative enhancement (decrease of parenchymal signal intensity). Although a significant (p < 0.0001) C/N increase was seen after MnDPDP administration for all sequences, STIR showed the highest increase (149.0 +/- 25.5%) compared with T1-weighted SE (58.5 +/- 12.7%) and GE (83.3 +/- 7.2%) sequences. Similarly, more lesions for all sequences were detected, but again STIR showed the greatest postcontrast increase (29.0%). MnDPDP is an effective hepatic contrast agent. As both the negative hepatic enhancement and the increase in lesion-to-liver C/N were superior with the STIR sequence when compared with the positive enhancement and C/N values produced by the T1-weighted sequences, it should be considered for inclusion in the imaging protocol for patients with focal liver disease.
Insights
Manganese dipyridoxyl diphosphate (MnDPDP) effectively enhances liver imaging. The short inversion time IR MRI (STIR) sequence showed superior lesion detection and contrast compared to other MRI sequences when using MnDPDP.
Area of Science:
- Radiology
- Medical Imaging
- Hepatobiliary Imaging
Background:
- Manganese dipyridoxyl diphosphate (MnDPDP) is a potential negative hepatic contrast agent.
- Assessing its utility in Short Inversion Time IR MRI (STIR) is crucial for liver lesion detection.
Purpose of the Study:
- To evaluate MnDPDP as a negative hepatic contrast agent in STIR MRI.
- To compare the effectiveness of MnDPDP across different MRI sequences for focal liver lesions.
Main Methods:
- Twenty patients with focal liver lesions underwent MRI (T1-weighted SE, GE, STIR) before and after MnDPDP infusion.
- Comparison of hepatic parenchymal enhancement, lesion-to-liver contrast-to-noise ratio (C/N), and lesion detection rates.
Main Results:
- STIR sequence demonstrated significant negative hepatic enhancement (78.9%).
- MnDPDP significantly increased lesion-to-liver C/N across all sequences, with STIR showing the highest increase (149.0%).
- STIR sequence also showed the greatest postcontrast increase in detected focal liver lesions (29.0%).
Conclusions:
- MnDPDP is an effective hepatic contrast agent.
- The STIR sequence offers superior negative hepatic enhancement and improved lesion conspicuity with MnDPDP compared to T1-weighted sequences.
- MnDPDP with STIR MRI should be considered for imaging protocols in patients with focal liver disease.