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American Journal of Roentgenology, Vol 168, 689-696, Copyright © 1997 by American Roentgen Ray Society

ARTICLES

Dynamic contrast-enhanced FMPSPGR of the pancreas: impact on diagnostic performance

SC Gohde, J Toth, GP Krestin and JF Debatin
Department of Diagnostic Radiology, Zurich University Hospital, Switzerland.

OBJECTIVE: The objective of this study was to evaluate the diagnostic impact of dynamic contrast-enhanced fast multiplanar spoiled gradient- recalled imaging (FMPSPGR) of the pancreas. MATERIALS AND METHODS: MR imaging examinations of the upper abdomen for 101 patients were evaluated retrospectively and compared with histologic and surgical results as well as imaging or laboratory and clinical follow-up results. Standard T1-weighted spin-echo images, T2-weighted fast spin- echo images with fat saturation, and FMPSPGR had been obtained for all patients. Of the 101 patients, 79 also underwent fat-saturated contrast- enhanced T1-weighted spin-echo MR imaging. Qualitative analysis consisted of evaluation of overall image quality and characterization of the pancreas as normal or abnormal, for which receiver operating characteristic curves were calculated. A contrast-to-noise ratio between the pancreas and the surrounding tissue was calculated for each patient. RESULTS: By a statistically significant margin, FMPSPGR performed better than conventional spin-echo MR imaging. For FMPSPGR, sensitivity and specificity were 87% and 100%, respectively, compared with T1-weighted spin-echo sequences (sensitivity, 50%; specificity, 96%), T2-weighted spin-echo sequences with fat saturation (sensitivity, 60%; specificity, 93%), and contrast-enhanced T1-weighted spin-echo sequences with fat saturation (sensitivity, 53%; specificity, 90%). Diagnostic confidence was highest with FMPSPGR. CONCLUSION: FMPSPGR should be used in all MR imaging examinations of the upper abdomen. This technique offers better visualization of important structures and increases confidence for a more specific and accurate diagnosis than does conventional spin-echo imaging.
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Copyright © 1997 by the American Roentgen Ray Society.