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At least 19 recordsLinked to original sources
PubMed2002

3D contrast-enhanced MR portography and direct X-ray portography: a correlation study.

Our objective was to compare 3D contrast-enhanced MR portography (3D CE MRP) on a 1.5-T MR imager with direct X-ray portography. Twenty-six consecutive patients underwent 3D CE MRP with in-plane resolution of 1.4 or 1.8 mm, and direct X-ray portography. The findings of these two methods were evaluated and compared. The main portal vein (PV), right PV with its anterior and posterior segmental branches, and left PV including its sagittal segment were shown clearly without diagnostic problem in all cases on MRP. The main PV appearance was accordant with MRP and X-ray. For intrahepatic PVs, the results agreed in 21 patients but disagreed in 5 patients. In 1 patient with a huge tumor in right liver, the right posterior PV was classified as occluded at MRP, but diffusely narrowed at X-ray. The findings of left intrahepatic PV were discordant in 3 patients with hepatocelluar carcinoma in the left lobe. The MRP demonstrated complete occlusion of the left PVs, whereas X-ray showed proximal narrowing and distal occlusion. In another patient with hepatocelluar carcinoma, a small non-occlusive thrombus involving the sagittal segment of the left PV was seen on MRP but not on X-ray. With demonstration of varices and portosystemic shunts, MRP showed results similar to those of X-ray, except one recanalized para-umbilical vein was excluded from the field of view at MRP due to the patient's limited ability of breathholding. The 3D CE MRP correlated well with direct X-ray portography in most cases, it was limited in distinguishing narrowing of an intrahepatic PV from occlusion, but it showed advantage in demonstrating small thrombus within PV.

Adult↗
PubMedDate not supplied

MR portography: preliminary comparison with CT portography and conventional MR imaging.

Magnetic resonance (MR) imaging with arterial portography (MRAP) was compared with computed tomography with arterial portography (CTAP) and conventional MR imaging for preoperative evaluation of hepatic masses in eight patients (nine studies). Twenty contiguous, 10-mm-thick-section CTAP images were obtained. MR imaging included T1- and T2-weighted spin-echo and fast multiplanar SPGR (spoiled gradient-recalled acquisition in the steady state) techniques. For MRAP, 0.1 mmol/kg gadopentetate dimeglumine was injected into the superior mesenteric artery. Portographic-phase, 8-mm-thick-section, axial SPGR images were first obtained, followed by "systemic phase" SPGR images. Lesions were seen best on the portographic-phase MRAP images and were less conspicuous on the systemic-phase MRAP, CTAP and conventional MR images. Of 19 visualized lesions, 18 were seen with MRAP; however; five subcentimeter lesions seen with MRAP were not seen with conventional MR imaging or CTAP. Systemic recirculation of iodinated contrast material from the bolus and from previous angiography is a potential limitation of CTAP. For both CTAP and MRAP, optimal results are expected if all images are obtained during a single breath hold, within seconds of the onset of contrast agent administration.

Contrast Media↗
PubMedDate not supplied

Homogeneous enhancement of hepatic parenchyma: MR imaging during arterial portography versus CT during arterial portography.

BACKGROUND: The goal of this study was to investigate the frequency of inhomogeneous parenchymal enhancement of the liver in magnetic resonance imaging during arterial portography (MRAP) versus computed tomography during arterial portography (CTAP). METHODS: CTAP and MRAP were performed in 29 and in 21 patients, respectively, who had suspected primary or secondary liver tumors on clinical or biological grounds. We evaluated the frequency of inhomogeneous hepatic parenchymal enhancement not related to a decrease of portal blood supply due to compression or obstruction by the tumor and physiologic variation in portal perfusion. Inhomogeneous parenchymal enhancement of the liver was classified as segmental or subsegmental and as nonsegmental. RESULTS: Segmental or subsegmental inhomogeneous parenchymal enhancement was seen in six of 29 patients (20.1%) on CTAP and in one of 21 patients (4.8%) on MRAP. Nonsegmental inhomogeneous parenchymal enhancement was seen in five of 29 patients (17.2%) on CTAP images and in none of the patients (0%) on MRAP images. The incidence of nonsegmental inhomogeneous parenchymal enhancement was significantly lower on MRAP than on CTAP. CONCLUSION: MRAP was superior to CTAP in achieving homogeneous parenchymal enhancement of the liver.

Aged↗
PubMed2006

Ultrafine needle CO2 splenoportography: a comparative investigation with transarterial portography and MR portography.

PURPOSE: To evaluate the safety and quality of CO2 splenoportography (CO2-SP) by comparison to 3-dimensional dynamic contrast-enhanced magnetic resonance portography (3D-DCE-MRP) and transarterial portography (TAP). MATERIALS AND METHODS: CO2-SP, 3D-DCE-MRP and TAP were performed within 3 days in 35 patients. CO2-SP was conducted with a 26G needle by puncture of spleen under fluoroscopy and/or ultrasound guidance. A fifty mm3 of CO2 was manually injected within 3s. The safety and the side effects of CO2-SP were assessed with a scoring system based on both the subjective feeling of patients questioned and the objective appearances of vital signs, electrocardiogram (ECG) and saturation of percutaneous blood oxygen (SpO2). The quality of the imaging was compared among the three groups using different methods by a scoring criterion based on visualization of the portal branches. RESULTS: Transient mild discomfortable reaction was present in 18 patients (51.4%). The scores measured for quality of portal vein branch visualization in the groups with CO2-SP, 3D-DCE-MRP and TAP were 226, 196 and 167, respectively (P<0.001, the higher of the scores, the better of the quality). The visibility of collateral veins was not significantly different amongst the three imaging techniques. CONCLUSION: Ultrafine needle CO2-SP is safe and minimally invasive. The quality of CO2-SP is better than that with 3D-DCE-MRP and TAP in terms of the visualizing portal vein branches.

Adult↗
PubMed2006

Comparison of CT during arterial portography and MR during arterial portography in the detection of liver metastases.

OBJECTIVE: This study compared MR during arterial portography (MRAP) with CT during arterial portography (CTAP) with regard to the detection and differentiation of liver metastases before surgery. MATERIALS AND METHODS: Fifteen patients with liver metastases were enrolled before surgery according to the guidelines of our institutional review board and good clinical practice. After mesentericography, unenhanced scans (Volume Zoom) were performed initially. For CTAP, the contrast medium was injected through the superior mesenteric artery. Images were acquired in portal and delayed enhancement. The MR protocol (1.5 T; Magnetom Symphony) started with T1-weighted fast low-angle shot (FLASH) T2-weighted turbo spin echo (TSE). MRAP followed with gadolinium-enhanced dynamic T1-weighted 3D FLASH. Delayed-phase T1-weighted 2D FLASH axial images were performed 2 min after IV injection of the contrast medium. Qualitative and quantitative evaluation of CTAP and MRAP was performed by three blinded radiologists regarding the number of lesions and their size, localization, and differential diagnosis. RESULTS: The overall sensitivity in detecting liver metastases was 97% with MRAP and 93% with CTAP (p > 0.05, not significant [n.s.]). The specificity was calculated to be 97% for MRAP and 82% for CTAP (p < 0.0001, statistically significant [s.s.]). The differences in sensitivity were more accentuated if only lesions 10 mm or smaller were considered (95% vs 88%, p > 0.05, n.s.), for which the respective specificities were 95% and 80% (p < 0.0014, s.s.). Improvements in sensitivity and specificity were associated with a higher lesion-to-liver contrast-to-noise ratio (59.4 +/- 51.0 for MRAP vs 10.4 +/- 7.3 for CTAP) and resulted in higher diagnostic confidence in the differential diagnosis of liver lesions (p < 0.001, s.s.) and better interobserver agreement (median kappa value, 0.88 vs 0.63). CONCLUSION: MRAP proved to be a reliable method in the preoperative detection of small liver metastases in particular, with a higher sensitivity and specificity than CTAP. If organizational difficulties of MRAP can be overcome, MRAP could be considered instead of CTAP in the preoperative invasive evaluation of metastatic liver disease.

Adult↗
PubMed1998

MR imaging during arterial portography for assessment of hepatocellular carcinoma: comparison with CT during arterial portography.

OBJECTIVE: The purpose of this study was to document the usefulness of MR imaging during arterial portography (MRAP) versus CT during arterial portography (CTAP) in the diagnosis and assessment of hepatocellular carcinoma. SUBJECTS AND METHODS: In addition to static T1- and T2-weighted MR imaging, MRAP was performed immediately after hepatic angiography through contrast material injection into intraarterially placed catheters (superior mesenteric or splenic artery) in 21 patients with nodular hepatocellular carcinoma. CTAP was performed afterward for each patient. The sensitivity and specificity of MRAP for lesion detection and the differential diagnosis of hepatocellular carcinoma were compared with the sensitivity and specificity of CTAP. RESULTS: MRAP revealed more perfusion defects (n = 56) than did CTAP (n = 46). The sensitivity for detection of hepatocellular carcinoma was higher for MRAP (94%) than for CTAP (83%); however, the difference was not statistically significant (p > .05). More hepatocellular nodules with unknown malignant potential were revealed on MRAP (n = 7) than on CTAP (n = 2). For the differential diagnosis of perfusion defects commonly revealed by both techniques, more benign lesions and pseudolesions (n = 14) were shown on MRAP through the combined interpretation with static images than on unenhanced and contrast-enhanced CTAP (n = 11). CONCLUSION: Because of its high sensitivity and its ability to enable radiologists to differentiate benign from malignant conditions, MRAP may have merit compared with CTAP in the assessment of hepatocellular carcinoma.

Adult↗
PubMed2001

Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices.

OBJECTIVE: This study seeks to evaluate three-dimensional (3D) helical CT portography as a tool for examining patients with gastric fundic varices. SUBJECTS AND METHODS: We compared 3D helical CT portography and conventional angiographic portography in 30 consecutive patients with gastric fundic varices. We assessed whether 3D helical CT portography is useful in selecting patients and in evaluating the results of balloon-occluded retrograde transvenous obliteration. RESULTS: Three-dimensional helical CT portography simultaneously depicted second or third branches of the intrahepatic portal vein and provided images of entire portosystemic collaterals. On 3D helical CT portography, gastric fundic varices were seen in 30 patients (100%), left gastric veins in 19 (63%), posterior gastric veins or short gastric veins in 28 (93%), gastrorenal shunts in 27 (90%), paraumbilical veins in three (10%), and inferior phrenic veins in two patients (7%). Findings of 3D helical CT portography and conventional angiographic portography were in close agreement. However, in four patients, posterior gastric veins or short gastric veins were not seen on conventional angiographic portography images of the spleen, but they were clearly revealed on 3D helical CT portography. Treatment was successful in all patients except one. Three-dimensional helical CT portography could easily evaluate therapeutic results. CONCLUSION: Three-dimensional helical CT portography proved so effective that it can be considered a less invasive alternative than conventional angiographic portography in assessing portosystemic collaterals. CT portography is useful in selecting candidates from patients with gastric fundic varices for retrograde transvenous obliteration and also in evaluating therapeutic results.

Adult↗
PubMed2000

Revealing hepatic metastases from colorectal cancer: value of combined helical CT during arterial portography and CT hepatic arteriography with a unified CT and angiography system.

OBJECTIVE: The purpose of our study was to evaluate the use of combined helical CT during arterial portography and CT hepatic arteriography in the preoperative assessment of hepatic metastases from colorectal cancer using a unified CT and angiography system. MATERIALS AND METHODS: Fifty-four patients with hepatic metastases from colorectal cancer preoperatively underwent combined CT during arterial portography and CT hepatic arteriography using the unified CT and angiography system. Three radiologists independently and retrospectively reviewed the images of CT during arterial portography alone, CT hepatic arteriography alone, and combined CT during arterial portography and CT hepatic arteriography. Image review was conducted on a segment-by-segment basis; a total of 432 hepatic segments with (n = 103) 118 metastatic tumors ranging in size from 2 to 160 mm (mean, 25.8 mm) and without (n = 329) tumor were reviewed. RESULTS: Relative sensitivity of combined CT during arterial portography and CT hepatic arteriography (87%) was higher than that of CT during arterial portography alone (80%, p < 0.0005) and CT hepatic arteriography alone (83%, p < 0.005). Relative specificity of CT hepatic arteriography alone (95%, p < 0.0005) and combined CT during arterial portography and CT hepatic arteriography (96%, p < 0.0001) was higher than that of CT during arterial portography alone (91%). Diagnostic accuracy, determined by a receiver operating characteristic curve analysis, was greater with combined CT during arterial portography and CT hepatic arteriography than with CT during arterial portography alone (p < 0.05) or CT hepatic arteriography alone (p < 0.01). CONCLUSION: Using a unified CT and angiography system, we found that combined CT during arterial portography and CT hepatic arteriography significantly raised the detectability of hepatic metastases from colorectal cancer.

Adult↗
PubMed1993

Preoperative determination of the resectability of hepatic tumors: efficacy of CT during arterial portography.

OBJECTIVE: A multiinstitutional study was performed to evaluate the efficacy of CT during arterial portography for determining the resectability of hepatic tumors. The impact of findings from CT during arterial portography on patients' treatment (i.e., surgical vs nonsurgical) was assessed. In patients considered to have resectable tumors, the accuracy of CT during arterial portography for predicting surgical findings was also evaluated. MATERIALS AND METHODS: A retrospective study was done of 404 patients from three institutions who had CT during arterial portography during the period 1985-1991 as part of preoperative staging to determine the resectability of hepatic tumors. The tumors included metastases from colorectal carcinoma in 197 patients (49%); other hepatic metastases, mostly from adenocarcinoma of the stomach, pancreas, and biliary tree in 123 (30%); and primary hepatocellular carcinoma in 84 (21%). Imaging results were correlated with results of percutaneous biopsy of at least one hepatic lesion in patients whose tumors were considered unresectable. In patients whose tumors were considered resectable, results were correlated with preoperative percutaneous biopsy (obtained in almost all cases) and pathologic examination of a surgical specimen (all cases). Although each case was considered individually, four criteria were used for resectability: (1) accessibility of all lesions to lobar or wedge resection that would yield clear margins, (2) anticipation that residual liver tissue after resection would provide sufficient function, (3) the absence of invasion of central hepatic vascular or biliary structures, and (4) the absence of extrahepatic disease. No specific restriction was made with respect to the number of hepatic lesions present. The accuracy of findings by CT during arterial portography for predicting resectability was assessed in the 146 patients who had tumors that were considered resectable on the basis of imaging findings and had surgery. RESULTS: Of 404 patients, only 146 (36%) were thought to be candidates for resection on the basis of findings from CT during arterial portography. Of these, 122 (84%) actually had resection. The 24 patients who did not have resection included 22 patients with disease understaged or overstaged by CT during arterial portography, one with true-negative findings by CT during arterial portography, and one who died during surgery. The accuracy of findings by CT during arterial portography for predicting results at surgery was 85% for all patients and 91% for the subset of patients who had primary colorectal tumors with hepatic metastases. CONCLUSION: Our experience shows that CT during arterial portography is a useful procedure for assessing the resectability of hepatic tumors. In our study, 64% of patients were spared unnecessary surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Carcinoma↗
PubMedDate not supplied

CT portography by multidetector helical CT: comparison of three rendering models.

PURPOSE: To assess the value of multidetector CT portography in visualizing varices and portosystemic collaterals in comparison with conventional portography, and to compare the visualizations obtained by three rendering models (volume rendering, VR; minimum intensity projection, MIP; and shaded surface display, SSD). METHODS: A total of 46 patients with portal hypertension were examined by CT and conventional portography for evaluation of portosystemic collaterals. CT portography was performed by multidetector CT (MD-CT) scanner with a slice thickness of 2.5 mm and table feed of 7.5 mm. Three types of CT portographic models were generated and compared with transarterial portography. RESULTS: Among the 46 patients, 48 collaterals were identified on CT transverse images, while 38 collaterals were detected on transarterial portography. Forty-four of 48 collaterals identified on CT transverse images were visualized with the MIP model, while 34 and 29 collaterals were visualized by the VR and SSD methods, respectively. The average CT value for the portal vein and varices was 198 HU with data acquisition of 50 sec after contrast material injection. CONCLUSIONS: CT portography by multidetector CT provides excellent images in the visualization of portosystemic collaterals. The images of collaterals produced by MD-CT are superior to those of transarterial portography. Among the three rendering techniques, MIP provides the best visualization of portosystemic collaterals.

Collateral Circulation↗
PubMed2004

Magnetic resonance portography using contrast-enhanced fat-saturated three-dimensional steady-state free precession imaging.

PURPOSE: To assess the feasibility of contrast-enhanced fat-saturated three-dimensional steady-state free precession (FIESTA) imaging for contrast-enhanced magnetic resonance (MR) portography. MATERIALS AND METHODS: Contrast-enhanced fat-saturated three-dimensional fast spoiled gradient-echo (SPGR) and FIESTA were performed as MR portography. In 10 cases, fat-saturated three-dimensional FIESTA was first performed and followed by fast SPGR, and the order of post-contrast imaging was reversed in the other 10 cases. Signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) were estimated for portal and visceral veins on the source images. The visualization of portal vein was scored on three-dimensional MR portography. Portal venous system disorders were assessed using three-dimensional MR portography. RESULTS: The SNRs, CNRs, and visual assessment of portal and visceral veins were significantly higher in contrast-enhanced fat-saturated three-dimensional FIESTA than contrast-enhanced fat-saturated three-dimensional fast SPGR (P < 0.05). The contrast-enhanced fat-saturated three-dimensional FIESTA provided high venous signals even at 8 minutes after gadolinium injection. The abnormalities of portal venous system were well visualized with MR portography using contrast-enhanced fat-saturated three-dimensional FIESTA. CONCLUSION: Contrast-enhanced fat-saturated three-dimensional FIESTA was valuable for MR portography, with flexible time window and high vascular signals. This imaging may allow for other post-contrast imaging options before portography and release patients from consecutive breath-holds.

Adult↗
PubMed2006

Prospective, blinded comparison of helical CT and CT arterial portography in the assessment of hepatic metastasis from colorectal carcinoma.

OBJECTIVE: This prospective blinded comparison of helical CT and helical CT arterial portography aimed to detect liver metastasis from colorectal carcinoma. METHODS AND MATERIALS: 50 patients with colorectal carcinoma were evaluated comparing helical CT with helical CT arterial portography. Each imaging study was evaluated on a 5-point ROC scale by radiologists blinded to the other imaging findings, and the results were compared, with the surgical and pathologic findings as the gold standard. RESULTS: Of the 127 lesions found at pathology identified as metastatic colorectal cancer, helical CT correctly identified 85 (69%) and CT portography 96 (76%). When subgroups with lesions <3 cm (48 patients) and patients with maximum tumor size <3 cm (18 patients) were considered, CT portography was always better than helical CT in terms of sensitivity, specificity, positive predictive value, and negative predictive value. ROC analysis adjusting for multiple lesions per patient revealed significantly greater area under the curve (AUC) for the subgroup of lesions <3 cm (CT-AUC of 77% and CT portography AUC of 81%; P = 0.002). CONCLUSIONS: For identification of large metastases, helical CT and CT portography have similar yield. However, for detection of small liver metastases, CT portography remains superior for lesion detectability.

Colorectal Neoplasms↗
PubMed1992

Preoperative assessment of resectability of hepatic metastases from colonic carcinoma: CT portography vs sonography and dynamic CT.

OBJECTIVE: A retrospective study was performed to determine the influence of CT portography vs sonography and dynamic CT on the preoperative assessment of the resectability of hepatic metastases from colorectal cancer. MATERIALS AND METHODS: Results of sonography, bolus dynamic CT, and CT portography in 28 patients who underwent surgical exploration (resection or intraarterial catheter placement) for hepatic metastases from colorectal cancer were retrospectively reviewed by two abdominal radiologists and one hepatic surgeon. For each patient, the resectability and surgical approach were decided on the basis of the results of combined sonography-bolus dynamic CT and compared with the decision made from the CT portographic results alone. The final approach suggested was compared retrospectively with the surgical procedure actually performed. RESULTS: Sixty-nine metastases were identified at surgery and pathologically proved. Combined sonography-bolus dynamic CT and CT portography showed 52 (75%) and 64 (93%) metastases, respectively. Twelve metastases in five patients were seen only with CT portography. In four patients, CT portography depicted additional metastases, which changed the surgical approach that had been chosen on the basis of results of sonography and bolus dynamic CT. In one patient, CT portography showed four additional metastases, precluding hepatic resection. CONCLUSION: Findings from CT portography provide vital data unattainable with sonography and bolus dynamic CT that improve the preoperative assessment of the resectability of liver metastases from colonic carcinoma.

Colorectal Neoplasms↗
PubMed1994

Detection of recurrent hepatic metastases after partial hepatectomy: value of CT combined with arterial portography.

OBJECTIVE: We did a retrospective study to evaluate the sensitivity of CT combined with arterial portography in detecting recurrent hepatic metastases after partial hepatectomy. MATERIALS AND METHODS: CT scans combined with arterial portography in 18 patients who had partial hepatectomy and suspected intrahepatic recurrence of metastases were retrospectively reviewed. Eleven of the patients had further surgery, and recurrent hepatic metastases were proved; seven patients were inoperable. The sensitivity of CT with arterial portography for detecting recurrent intrahepatic metastases was determined and correlated with intraoperative findings and findings on follow-up imaging studies in the 11 patients (with a total of 23 hepatic metastases) who had further surgery. RESULTS: Not one of the 18 CT examinations combined with arterial portography was compromised by inhomogeneous perfusion of contrast material in the portal vein. Of the 23 metastases that were found in the 11 patients who had further surgery, 21 (91%) were shown on CT with arterial portography. In two patients, CT with arterial portography showed two subcapsular hypoattenuating pseudolesions that were correctly identified as nontumorous perfusion defects, as confirmed by intraoperative findings and follow-up imaging studies. CONCLUSION: This study shows that postoperative CT with arterial portography is efficacious in the detection of intrahepatic recurrent metastases in patients who have had a partial hepatectomy. Furthermore, prior partial hepatectomy does not compromise the quality of this examination.

Colorectal Neoplasms↗
PubMed2005

Analysis of factors influencing hepatocellular carcinoma detection: efficient use of computed tomography during arterial portography and during hepatic arteriography.

BACKGROUND: This study was performed to investigate the situations in which computed tomography (CT) combined with arterial portography and hepatic arteriography surpassed dynamic CT in the detection of hepatocellular carcinoma. METHODS: Computed tomography combined with arterial portography and hepatic arteriography was performed on 137 patients with chronic hepatitis (92 men and 45 women; mean age, 66.5 years) with hepatocellular carcinoma (HCC) as revealed or suspected by dynamic CT. We analyzed the clinical factors leading to the discovery of additional HCC lesions on CT combined with arterial portography and hepatic arteriography that were undetected by dynamic CT. RESULTS: Computed tomography combined with arterial portography and hepatic arteriography detected additional HCC lesions that had not been revealed by dynamic CT in 33 of 137 patients. Univariate analysis revealed that in the event of HCC recurrence (vs. primary), multiple HCC lesions detected by dynamic CT (vs. single) and decreased liver function (Child's classification B/C vs. A) significantly favored the additional detection of HCC lesions. Multivariate logistic regression indicated that recurrence was the strongest predicting factor for finding additional lesions on computed tomography combined with arterial portography and hepatic arteriography. CONCLUSIONS: Computed tomography combined with arterial portography and hepatic arteriography is capable of finding additional HCC lesions undetectable by dynamic CT, especially in advanced cases such as HCC recurrence, which may affect the choice of treatment.

Aged↗
PubMed1994

Single breath-holding three-dimensional magnetic resonance portography with bolus injection of Gd-DTPA in subjects with normal liver: a comparison with two-dimensional time-of-flight technique.

Two-dimensional time-of-flight (2D-TOF) magnetic resonance (MR) portography tends to produce general image degradation owing to the phase discrepancy caused by multiple breath-holding. To solve this problem, three-dimensional (3D)-MR portographies were reconstructed from image data acquired with a bolus injection of Gd-DTPA with single breath-holding in 20 subjects with normal liver function. 2D-TOF MR portographies were obtained beforehand for the comparison. All the images were displayed in a cine mode for the two MR angiographic techniques. Visualization was assessed as positive when the vessel was visualized without disruption. 3D-MR portography produced a positive rate of over 80% for all but the left first-order branch. With the 2D-TOF techniques, however, only the portal trunk and left second-order branches were visualized at this rate. The positive rate for most portal branches was significantly higher with 3D-MR portography than with the 2D-TOF technique. In conclusion, 3D-MR portography makes it possible to depict the portal venous system without disruption using a short measurement time with single breath-holding and has the potential to become a powerful method for abdominal MR angiography.

Adult↗
PubMed2001

Preoperative detection of hepatocellular carcinoma: ferumoxides-enhanced mr imaging versus combined helical CT during arterial portography and CT hepatic arteriography.

OBJECTIVE: The purpose of this study was to compare ferumoxides-enhanced MR imaging with combined helical CT during arterial portography and CT hepatic arteriography for preoperative detection of hepatocellular carcinomas. SUBJECTS AND METHODS: Twenty patients with 30 hepatocellular carcinomas underwent ferumoxides-enhanced MR imaging and combined helical CT during arterial portography and CT hepatic arteriography. The diagnosis was established by pathologic examination after surgical resection in 18 patients and by biopsy in two. The MR protocol included fast spin-echo with two echo times, T2(*)-weighted fast multiplanar gradient-recalled acquisition in the steady state, proton density-weighted fast multiplanar spoiled gradient-recalled echo, and T1-weighted fast multiplanar spoiled gradient-recalled echo images. The MR images of all sequences and the paired CT during arterial portography and CT hepatic arteriography images were independently evaluated by three radiologists on a segment-by-segment basis. Diagnostic accuracy was assessed with receiver operating characteristic analysis. RESULTS: The accuracies (A(z) values) of ferumoxides-enhanced MR imaging and combined CT during arterial portography and CT hepatic arteriography for all observers were 0.964 and 0.948, respectively. The mean sensitivities of MR imaging and CT were 93% and 91%, respectively. The differences were not statistically significant. The mean specificity of MR imaging (99%) was significantly higher than that of combined CT during arterial portography and CT hepatic arteriography (94%). CONCLUSION: Ferumoxides-enhanced MR imaging can be used successfully in place of combined CT during arterial portography and CT hepatic arteriography for the preoperative evaluation of patients with hepatocellular carcinomas.

Adult↗