Extended diagnosis of liver tumor with gadolinium DTPA supplementary to routine procedure in nuclear medicine

Several imaging methods and especially their combined application are proven to be useful in the diagnosis and differentiation of liver tumors: Ultrasound, roentgen computed tomography, sequential hepatobiliary scintigraphy (HBSS), blood pool scintigraphy and magnetic resonance imaging. 38 patients with liver tumors (hemangioma, hepatocellular carcinoma, focal nodular hyperplasia) underwent MRI of the liver before and after i.v. injection of 0.2 mmol/kg Gadolinium-DTPA in addition to other imaging methods. Written informed consent we achieved in all cases. The normal and pathological findings in MRI were documented in T1- and T2-weighted images, proton density image, calculated T1- and T2-images and a T1-weighted image after application of the contrast agent. The application of Gadolinium-DTPA as contrast agent improves the delimitation of the most intrahepatic lesions. Concerning the hemangiomas of the liver the improved contrast behaviour induced by Gadolinium-DTPA does not reach the contrast and sensitivity of a native T2-weighted SE image. The demarcation of focal nodular hyperplasia is not improved by use of the contrast agent. This finding supports the assumption that the FNH is not basically different from normal liver tissue. Gadolinium-DTPA provides additional information concerning the delineation of internal tumor details in hepatocellular carcinoma (hyperperfused areas, necroses, fibrous capsular structures). (orig.)