By Guy Marchal MD (auth.), Andreas Heuck MD, Maximilian Reiser MD (eds.)
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Additional resources for Abdominal and Pelvic MRI
These features reflect the presence the use of MR contrast agents have helped to im- of blood degradation products such as methemogloprove the diagnostic specificity of MRI, its overall bin, ferritin, and hemosiderin. Areas of fibrosis accuracy in the diagnosis of cavernous heman- and intratumoral necrosis may appear hypointense giomas is still only about 90%. While the differentia- on Tl-weighted images, with the latter being hypertion of hypervascular metastases can be improved intense on T2-weighted images (RUMMENY et al.
Results with MRI are not influenced by uneven perfusion of liver parenchyma due to fibrosis and frequently can provide accurate information on the presence or absence of HCC. CT with Lipiodol has reached a sensitivity of up to 92% (DE SANTIS et al. 1992), but this technique is not used in the United States in routine clinical practice. Therefore, MRI should be the initial test in patients with liver cirrhosis who are at risk for developing this tumor or in patients with elevated a-fetoprotein. In these patients, MRI is superior for detecting tumor and distinguishing between metastatic disease and HCC.
Often, MRI readily distinguishes between bland thrombus and tumor thrombus. Even though the final role of MRI in the armamentarium of imaging techniques for the liver is not completely defined, distinctive MRI features for characterization of malignant liver lesions have been recognized. Gadolinium enhancement often adds to the characterization of focal liver lesions which are based on Tl- and T2-weighted sequences. F .. , MD, Professor of Radiology, Department of RadIOlogy, Box 0628, University of California, San Francisco, CA 94143-0628, USA which promise to further improve results with MRI.
Abdominal and Pelvic MRI by Guy Marchal MD (auth.), Andreas Heuck MD, Maximilian Reiser MD (eds.)