Evaluation of the accuracy of gadobenate dimeglumine-enhanced MR imaging in the detection and characterization of focal liver lesions.
Pirovano G, Vanzulli A, Marti-Bonmati L, Grazioli L, Manfredi R, Greco A, Holzknecht N, Daldrup-Link HE, Rummeny E, Hamm B, Arneson V, Imperatori L, Kirchin MA, Spinazzi A. AJR Am J Roentgenol 2000 Oct;175(4):1111-20
OBJECTIVE. We evaluated
the extent to which hepatic lesion characterization and detection
is improved by using gadobenate dimeglumine for enhancement of
MR images. MATERIALS AND METHODS. Eighty-six patients were imaged
before gadobenate dimeglumine administration, immediately after
the 2 mL/sec bolus administration of a 0.05 mmol/kg dose (dynamic
imaging), and at 60-120 min after the IV infusion at 10 mL/min
of a further 0.05 nmol/kg dose (delayed imaging). The accuracy
for lesion characterization was assessed for a total of 107 lesions.
Sensitivity for lesion detection was assessed for a total of 149
lesions detected on either intra-operative sonography, iodized
oil CT, CT during arterial portography, or follow-up contrast-enhanced
CT as the gold standard. RESULTS. The accuracy in differentiating
benign from malignant liver lesions increased from 75% and 82%
(the findings of two observers) on unenhanced images alone, to
89% and 80% on dynamic images alone (p<0.001, p = 0.8), and
to 90.7% when combining the unenhanced and dynamic image sets
(p<0.001, p = 0.023). Delayed images did not further improve
accuracy (90% and 91%; p = 0.002, p< 0.05). A similar trend
was apparent in terms of accuracy for specific diagnosis: values
ranged from 49% and 62% on unenhanced images alone, to 76% and
70% on combined unenhanced and dynamic images (p<0.001, p =
0.06), and to 75% and 70% on inclusion of delayed images (p<0.001,
p = 0.12). The sensitivity for lesion detection increased from
77% and 81% on unenhanced images alone, to 87% and 85% on combined
unenhanced and dynamic images (p = 0.001, p = 0.267), and to 92%
and 89% when all images were considered (p<0.001, p = 0.01).
CONCLUSION. Contrast-enhanced dynamic MR imaging with gadobenate
dimeglumine significantly increases sensitivity and accuracy over
unenhanced imaging for the characterization of focal hepatic lesions,
and delayed MR imaging contributes to the improved detection of
lesions.
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