J Korean Soc Magn Reson Med.  2010 Jun;14(1):31-40. 10.13104/jksmrm.2010.14.1.31.

Ferucarbotran-Enhanced Hepatic MRI at 3T Unit: Quantitative and Qualitative Comparison of Fast Breath-hold Imaging Sequences

• Cho KE
• Yu JS
• Chung JJ
• Kim JH
• Kim KW

• KMID: 1782991
• DOI: http://doi.org/10.13104/jksmrm.2010.14.1.31

Abstract

PURPOSE
To compare the relative values of various fast breath-hold imaging sequences for superparamagnetic iron-oxide (SPIO)-enhanced hepatic MRI for the assessment of solid focal lesions with a 3T MRI unit.
MATERIALS AND METHODS
102 consecutive patients with one or more solid malignant hepatic lesions were evaluated by spoiled gradient echo (GRE) sequences with three different echo times (2.4 msec [GRE_2.4], 5.8 msec [GRE_5.8], and 10 msec [GRE_10]) for T2*-weighted imaging in addition to T2-weighted turbo spin echo (TSE) sequence following intravenous SPIO injection. Image qualities of the hepatic contour, vascular landmarks and artifacts were rated by two independent readers using a four-point scale. For quantitative analysis, contrast-to-noise ratio (CNR) was measured in 170 solid focal lesions larger than 1 cm (107 hepatocellular carcinomas, nine cholangiocarcinomas and 54 metastases).
RESULTS
GRE_5.8 showed the highest mean points for hepatic contour, vascular anatomy and imaging artifact presence among all of the subjected sequences (p<0.001) and was comparable (p=0.414) with GRE_10 with regard to lesion conspicuity. The mean CNRs were significantly higher (p<0.001) in the following order: GRE_10 (24.4+/-14.5), GRE_5.8 (14.8+/-9.4), TSE (9.7+/-6.3), and GRE_2.4 (7.9+/-6.4). The mean CNRs of CCCs and metastases were higher than those of HCCs for all imaging sequences (p<0.05).
CONCLUSION
Regarding overall performances, GRE using a moderate echo time of 5.8 msec can provide the most reliable data among the various fast breath-hold SPIO-enhanced hepatic MRI sequences at 3T unit despite the lower CNR of GRE_5.8 compared to that of GRE_10.

Keyword

Liver neoplasm; Magnetic resonance (MR); Superparamagnetic iron oxide (SPIO)

MeSH Terms

Artifacts
Carcinoma, Hepatocellular
Chlormequat
Cholangiocarcinoma
Humans
Liver Neoplasms
Neoplasm Metastasis
Chlormequat

Figure

• 

  Fig. 1 A 59-year-old woman with a hepatocellular carcinoma in the cirrhotic liver. Among the four difference MRI sequences of fast imaging after ferucarbotran injection, turbo spin-echo image (a) shows worst quality in hepatic contour, vascular landmark and overall imaging artifact compared to gradient echo images using a TE of 2.4 msec (b) or 5.8 msec (c). Due to the serious pulsation artifact, the small hepatocellular carcinoma (arrowheads) in left lobe of the liver is not well defined on gradient echo imaging using a TE of 10 msec (d).

• 

  Fig. 2 A 51-year-old man with a hepatocellular carcinoma in segment 4 of the cirrhotic liver. After ferucarbotran injection, compared to turbo spin-echo image (a) or gradient echo image with a TE of 2.4 msec (b), gradient echo image with a TE of 5.8 msec (c) and gradient echo image with a TE of 10 msec (d) show better lesion (arrowheads) conspicuity.

• 

  Fig. 3 A 51-year-old woman with a hepatic metastasis from uterine cervix cancer. After ferucarbotran injection, turbo spin-echo image (a) shows better lesion (arrowheads) conspicuity compared to gradient echo image with a TE of 2.4 msec (b) and comparable with gradient echo with a TE of 5.8 msec (c) and gradient echo with a TE of 10 msec (d).

• 

  Fig. 4 Mean lesion-to-liver contrastto-noise ratio (CNR) of hepatic lesions on four different fast MRI sequences after ferucarbotran injection. The y axis indicates the mean lesion-to-liver CNR. TSE: turbo spin echo GRE_2.4: gradient echo with TE of 2.4 msec GRE_5.8: gradient echo with TE of 5.8 msec GRE_10: gradient echo with TE of 10 msec HCC: Hepatocellular carcinoma Mets: Metastasis CCC: Cholangiocellular carcinoma

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