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Comparison of CT During Arterial Portography and MR During Arterial Portography in the Detection of Liver Metastases

W. P. Hosch1, S. M. Schmidt1, S. Plaza1, C. Dechow1, J. Schmidt2, S. Ley3, G. W. Kauffmann1 and J. Hansmann1

1 Department of Radiology, University Clinic Heidelberg, INF 110, Heidelberg 69120, Germany.
2 Department of Surgery, University Clinic Heidelberg, Heidelberg, Germany.
3 Department of Radiology, German Cancer Research Center (DKFZ), Heidelburg, Germany.


Figure 1
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  		Fig. 1 —A Comparison between CT during arterial portography (A) and MR during arterial portography (B) of lesion-to-liver contrast of two metastases in right liver lobe (arrows) of 64-year-old man. Improvement of lesion-to-liver contrast lowers rate of false-negative findings.

 

Figure 2
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  		Fig. 1 —A Comparison between CT during arterial portography (A) and MR during arterial portography (B) of lesion-to-liver contrast of two metastases in right liver lobe (arrows) of 64-year-old man. Improvement of lesion-to-liver contrast lowers rate of false-negative findings.

 

Figure 3
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  		Fig. 2 —Evaluation of contrast homogeneity of liver parenchyma on CT during arterial portography (gray bars) and MR during arterial portography (black bars) after contrast medium administration (n = 45, 15 patients by three radiologists).

 

Figure 4
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  		Fig. 3 —Diagnostic confidence in evaluating hepatic liver lesions with CT during arterial portography (n =234) (gray bars) and MR during arterial portography (n = 252) (black bars).

 

Figure 5
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  		Fig. 4A —64-year-old man with hemangioma of right liver lobe. CT images before contrast medium application (A), during arterial portography (B), and during delayed enhancement (C). Because of findings at CT during arterial portography and during contrast enhancement, all observers misinterpreted lesion as malignant.

 

Figure 6
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  		Fig. 4B —64-year-old man with hemangioma of right liver lobe. CT images before contrast medium application (A), during arterial portography (B), and during delayed enhancement (C). Because of findings at CT during arterial portography and during contrast enhancement, all observers misinterpreted lesion as malignant.

 

Figure 7
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  		Fig. 4C —64-year-old man with hemangioma of right liver lobe. CT images before contrast medium application (A), during arterial portography (B), and during delayed enhancement (C). Because of findings at CT during arterial portography and during contrast enhancement, all observers misinterpreted lesion as malignant.

 

Figure 8
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  		Fig. 4D —64-year-old man with hemangioma of right liver lobe. Images from T1-weighted fast low-angle shot (FLASH) (D), T2-weighted turbo spin-echo (E), MR during arterial portography [MRAP] (F), T1-weighted FLASH during delayed enhancement (G). Progressing peripheral enhancement during dynamic contrast enhancement is more visible during MRI because of application of full systemic dose of contrast medium during MRAP. Using MRI, all observers correctly characterized this lesion as benign because of hyperintensity in T2-weighted turbo spin-echo and peripheral enhancement in delayed enhancement.

 

Figure 9
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  		Fig. 4E —64-year-old man with hemangioma of right liver lobe. Images from T1-weighted fast low-angle shot (FLASH) (D), T2-weighted turbo spin-echo (E), MR during arterial portography [MRAP] (F), T1-weighted FLASH during delayed enhancement (G). Progressing peripheral enhancement during dynamic contrast enhancement is more visible during MRI because of application of full systemic dose of contrast medium during MRAP. Using MRI, all observers correctly characterized this lesion as benign because of hyperintensity in T2-weighted turbo spin-echo and peripheral enhancement in delayed enhancement.

 

Figure 10
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  		Fig. 4F —64-year-old man with hemangioma of right liver lobe. Images from T1-weighted fast low-angle shot (FLASH) (D), T2-weighted turbo spin-echo (E), MR during arterial portography [MRAP] (F), T1-weighted FLASH during delayed enhancement (G). Progressing peripheral enhancement during dynamic contrast enhancement is more visible during MRI because of application of full systemic dose of contrast medium during MRAP. Using MRI, all observers correctly characterized this lesion as benign because of hyperintensity in T2-weighted turbo spin-echo and peripheral enhancement in delayed enhancement.

 

Figure 11
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  		Fig. 4G —64-year-old man with hemangioma of right liver lobe. Images from T1-weighted fast low-angle shot (FLASH) (D), T2-weighted turbo spin-echo (E), MR during arterial portography [MRAP] (F), T1-weighted FLASH during delayed enhancement (G). Progressing peripheral enhancement during dynamic contrast enhancement is more visible during MRI because of application of full systemic dose of contrast medium during MRAP. Using MRI, all observers correctly characterized this lesion as benign because of hyperintensity in T2-weighted turbo spin-echo and peripheral enhancement in delayed enhancement.

 

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