Udo Schmiedl

Comparison of initial biodistribution patterns of Gd-DTPA and albumin-(Gd-DTPA) using rapid spin echo MR imaging.

The initial biodistribution patterns of gadolinium-diethylenetria-minepentaacetic acid (Gd-DTPA), an extracellular fluid contrast agent, and human serum albumin, paramagnetically labeled with 19 Gd-DTPA groups and used as an intravascular agent, were compared in the brain, heart, liver, and major mediastinal vessels of rats. Repeated 4 s spin echo images acquired after injection of 0.2 mmol/kg Gd-DTPA demonstrated a maximum enhancement between 15 and 25 s of 57% in brain, 307% in heart, 220% in liver, 83% in subcutaneous tissue, and 380% in slowly flowing blood in mediastinal vascular structures. In the following 55 s there was a continuous decrease (average 45%) in signal intensity in each tissue except brain. Albumin-(Gd-DTPA), injected at a four times lower molar dose (0.045 mmol/kg) with respect to Gd-DTPA, demonstrated maximal enhancement of brain by 34%, heart by 237%, liver by 186%, and blood in mediastinal vessels by 325%. Gadolinium-DTPA, which rapidly diffuses from the small vessels into the interstitial space, was noted to accumulate in solid tissues and subsequently to be partially eliminated within 70 s of administration. Signal enhancement achieved with albumin-(Gd-DTPA) remained at a constant level over the 70 s observation period. These data further support the notion that albumin-(Gd-DTPA), due to its predominantly intravascular distribution, might be applied advantageously for the assessment of perfusion and blood-volume disorders.

Magnetic resonance imaging of myocardial infarction using albumin-(Gd-DTPA), a macromolecular blood-volume contrast agent in a rat model.

Magnetic resonance (MR) contrast enhancement of acute myocardial infarction was studied in rats using albumin-(Gd-DTPA), a paramagnetic macromolecule with prolonged intravascular retention after intravenous injection. Histologic examination and distribution measurements of radiolabeled microspheres confirmed induction of regional myocardial infarction after ligation of the left coronary artery. ECG-gated spin-echo images at 2.0 Tesla, employing short, T1-weighted pulse sequence settings, demonstrated time-persistent and significant (P less than .05) enhancement of normal myocardium (66%) and an even greater enhancement of the infarcted area (100%), for as long as 60 minutes after injection of 160 mg/kg albumin-(Gd-DTPA). The contrast difference between normal and infarcted myocardium was increased significantly (P less than .05) after administration of albumin-(Gd-DTPA). The prolonged enhancing effects of albumin-(Gd-DTPA) on MR images are useful for evaluating regional differences in blood volume and capillary integrity between normal and infarcted myocardium.

Magnetic Resonance Imaging of Local Soft Tissue Inflammation Using Gadolinium-DTPA

Chemical inflammation was induced subcutaneously in 10 rats using carrageenan mucopolysaccharide. Dual spin echo (SE) imaging of inflammatory loci was performed employing a 0.35 tesla resistive magnet. In addition, gadolinium-DTPA was administrated intravenously into 5 rats to evaluate the potential benefits of paramagnetic contrast medium for the detection and characterization of inflammatory loci. T2 weighted SE images demonstrated the edematous lesions as zones of high intensity. This was attributed to the increased relaxation times of lesions when compared to the adjacent soft tissue. The inflammation was also delineated on T1 weighted SE images, but only after injection of paramagnetic Gd-DTPA. Carrageenan mucopolysaccharide-in-duced lesions provide a useful experimental model for in vivo evaluation of soft tissue inflammation using magnetic resonance imaging. No special benefit of paramagnetic contrast enhancement was demonstrated in this model of local edema.

Mr Imaging of Urinary Bladder Neoplasms

The diagnostic potential of magnetic resonance (MR) imaging (MR) imaging at 1.5 T for assessment and staging of urinary bladder tumors was investigated in 10 patients with malignant urinary bladder tumors. All patients underwent complete pathologic staging. The appearance of the urinary bladder tumors and the ability to stage them by means of MR imaging was evaluated morphologically and compared with results obtained with pathologic examination. Magnetic resonance imaging permitted tumor localization in all patients. In nine patients the tumor stage was accurately determined by MR imaging. The smallest tumor detected by MR imaging was 1.5 cm. Both transverse and sagittal imaging planes were found to be essential for accurate assessment of tumor extension. Signal intensity data obtained from both dual and multi spin echo sequences showed that tumor display and depth if infiltration was best seen with a repetition time (TR) of 2,000 ms and an echo time (TE) of 90 ms. Accurate evaluation of perivesical tumor infiltration required a sequence with a TR 800 ms and a TE 30 ms. Data presented here further support the role of MR in staging urinary bladder neoplasms. Index Terms: Bladder, neoplasms—Carcinoma—Magnetic resonance imaging, techniques.

MR imaging of liver abscesses; application of Gd-DTPA☆

The potential utility of Gd-DTPA contrast enhancement of MR images in the evaluation of liver abscesses was assessed in rodents. Twelve rats with surgically implanted sterile liver abscesses were imaged at various stages of focal hepatic inflammation, 48 hours, 4 days, 7 days, 14 days and 21 days after lesion induction. Spin echo images, acquired before and repeatedly after intravenous injection of 0.2 mmol/kg Gd-DTPA, demonstrated improvement of the lesion-to-background contrast ranging from 2% to 40% depending on the stage of the disease. The enhancement pattern also varied with abscess evolution. Two, four and seven-day-old abscesses typically showed a ring enhancement, whereas two- and three-week-old abscesses presented largely homogeneously enhancing lesions. In the earlier lesions, contrast enhanced rim surrounding the low intensity center corresponded histologically to the formation of a capsule consisting of fibrous tissue and inflammatory cells. The center was necrotic. Data show that abscesses can be detected on images acquired with long repetition and echo times without injection of Gd-DTPA. The administration of Gd-DTPA, however, improved the lesion-to-background contrast and helped to define the abscess capsule evolution.

Focal lesions of the spleen: preliminary results with fast MR imaging at 1.5 T.

Sixteen patients with splenic lymphoma and six with nonlymphomatous splenic lesions underwent magnetic resonance (MR) imaging, ultrasound (US), and dynamic CT. All patients were studied at 1.5 T with gradient echo sequences using a repetition time of 80 ms, echo time of 16 ms, and two pulse angles of 30 and 60 degrees. In 14 patients with lymphomatous lesions fast MR showed circumscribed areas of low signal intensity at both pulse angles. The lesion-to-spleen contrast was better on images acquired with a pulse angle of 30 degrees. For fast MR with pulse angles of 30 degrees, the mean lesion-to-spleen contrast was similar to US and contrast-enhanced CT. However, with fast MR the contrast showed a lower variability and was considerably better than with unenhanced CT. In one patient fast MR showed splenic involvement that was missed on both CT and US. The signal characteristics of lymphomatous, leukemic, and sarcoid involvement and of healed infarcts were similar and indistinguishable on fast MR images. Recent splenic infarctions (three cases) were, however, distinctly different, characterized by regions of high signal intensity at both pulse angles. The results of this preliminary study suggest that fast MR imaging is a promising diagnostic tool for the assessment of splenic disorders.

MR characteristics of prostatic carcinoma and benign prostatic hyperplasia at 1.5 T.

Sixty-one patients with histologically proven disorders of the prostate [prostatic carcinoma (PC), 41; benign prostatic hyperplasia (BPH), 9; PC and BPH, 11] underwent magnetic resonance imaging at 1.5 T. Using single [spin echo (SE) 400/30] and dual (SE 1,600/30, 90) SE sequences, multislice contiguous scans were obtained in transverse, sagittal, and coronal planes through the prostate. In 27 patients (PC 14, BPH 6, PC and BPH 7) multiecho sequences with eight echoes (SE 1,600/30, 60,90,120,150,180, 210, 240) were acquired and T2 images were calculated in the planes with best depiction of circumscribed prostatic pathology. In these patients the Bhattacharyya coefficient, a quantitative criterion for the discrimination between normal and pathological tissue, derived by means of mathematical decision theory, was applied. This analysis showed the best discrimination between PC and normal prostate with echo time (TE) 90 and 120 ms [error rate (ER) for confusing these tissues 20–30%].There was no significant difference between the signal intensities of PC and BPH at any parameter setting, but PC could be discriminated from the compressed peripheral glandular regions that often accompany BPH [minimal ER (20–30%) at TE 90 and 120 ms].This distinction is of clinical value, since PC usually arises in the periphery of the prostate. Calculated T2 images did not show advantages for the detection of PC.