The role of Gd-BOPTA enhance MRI in the characterization of focal liver lesions

The contrasted MR researches today, have an important role in determining and characterizing the quantity and locations of focal liver tumors precisely.Gadobenate dimeglumine (Gd-BOPTA), different than the other contrast materials including gadolinium, serves both as an extra cellular contrast agent and a liver specific contrast agent. IV dose is kept by functional hepatocytes at a ratio of 3-5% and eliminated via gall. The contrast agent which is kept by liver cells extends the T1 relaxation period 2 times compared with the other conventional gadolinium including agents and allows liver parenchyma to be contrasted for a long time. (Nearly 40 ? 120 minutes) This contrasting property, allows the focal liver lesions to be discriminated from normal liver parenchyma at a higher ratio. Besides, the hepatospesific contrast agent is effective in discriminating the hepatocyte originated tumors from the other tumors.The purpose of this study, is to analyze the dynamic and late phase MR obtained by using Gd-BOPTA and determining the contrasting patterns of focal liver lesions and its contribution to lesion characterization.Totally 50 patients (27 male, 23 female) with ages between 18 and 77 (average: 55.98) who has primer or metastatic tumor (or tumor suspicion) in their livers were evaluated prospectively between March 2007 and April 2008 by ultrasonography and computerized tomography methods in Dokuz Eylül University Faculty of Medicine Radiology Department. 3 subjects were taken out of the study as no histopathologic diagnosis could be obtained or they got out of monitoring. 59 lesions were determined in 47 subjects that were incorporated to the study, The histopathologic diagnosis of 43 lesions were obtained.The MR analysis of all patients was implemented with a 1.5 Tesla MR device (Philips Gyroscan Intera Release 8, Eindhoven, Holland). The visualization sequences were selected dynamically as hepatobiliary phase, T1 Water Selective Excitation (WATS) 60 ? 90 minutes after, T2 Spectral Saturation with IR (SPIR), Single Shot T2, T1 fast field echo (FFE) in-phase (IP) and contrast material injection.The determined lesions were classified according to the dynamic analysis and the contrasting patterns they showed in hepatobiliary phase.When the contrasting patterns in hepatobiliary phase (60-90 min.) were evaluated, the it was observed that the HCC?s can show various contrasting patterns according to differentiation degree, residue hepatocyte functionality and lesion content. It was found out that the peripheral circular hypo intensity feature that is followed in metastasis, makes a significant contribution to the differentiation diagnosis. Especially hepatobiliary phase displays were observed to contribute to differentiation diagnosis in the evaluation of atypic FNH?s.As a result, it was observed that the hepatobiliary phase displays contributed significantly to the differentiation diagnosis of the lesions which especially doesn?t show specific properties in dynamic analysis.