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MR Imaging of Intrahepatic Cholangiocarcinoma

Use of Ferumoxides for Lesion Localization and Extension

Helio J. V. Braga1, Kursheed Imam and David A. Bluemke

1 All authors: Department of Radiology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287.



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  		Fig. 1A. —56-year-old man with peripheral cholangiocarcinoma. Unenhanced T2-weighted fast spin-echo MR image (TR/TE, 5000/99) reveals large mass in right lobe of liver.

 


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  		Fig. 1B. —56-year-old man with peripheral cholangiocarcinoma. Ferumoxides-enhanced T2-weighted fast spin-echo MR image (5000/99) at same level as A but obtained 30 min later depicts borders of this peripheral cholangiocarcinoma more clearly.

 


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  		Fig. 2A. —58-year-old man with hilar cholangiocarcinoma. Unenhanced T2-weighted fast spin-echo MR image (TR/TE, 4200/99) displays tumor (arrowheads) as minimally hyperintense to surrounding liver.

 


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  		Fig. 2B. —58-year-old man with hilar cholangiocarcinoma. Ferumoxides-enhanced T2-weighted fast spin-echo MR image (4200/99) at same level as A but obtained 30 min later shows how lesion (arrowheads) becomes more conspicuous and its extent along portal vein is better defined.

 


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  		Fig. 3A. —Difference in contrast-to-noise ratio before (gray bars) and after (black bars) use of ferumoxides. Bar graphs show increase in contrast-to-noise ratio (CNR) after use of ferumoxides in patients with cholangiocarcinoma (A) and colon metastases (B).

 


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  		Fig. 3B. —Difference in contrast-to-noise ratio before (gray bars) and after (black bars) use of ferumoxides. Bar graphs show increase in contrast-to-noise ratio (CNR) after use of ferumoxides in patients with cholangiocarcinoma (A) and colon metastases (B).

 


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  		Fig. 4A. —64-year-old man with colon metastasis. Unenhanced T2-weighted fast spin-echo MR image (TR/TE, 5000/85) shows tumor (arrowhead) as hyperintense to liver.

 


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  		Fig. 4B. —64-year-old man with colon metastasis. Ferumoxides-enhanced T2-weighted fast spin-echo MR image (4000/85) at same level as A but obtained 35 min later shows increased conspicuity of metastasis (arrowhead).

 

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