Liver and spleen enhancement after intravenous injection of carboxydextran magnetite: effect of dose, delay of imaging, and field strength in an ex vivo model

It has been predicted that liver and spleen enhancement after administration of superparamagnetic contrast agents may be different, depending on the strength of the main magnetic field. With the use of an ex vivo model, we investigated at 0.3, 0.5, and 1.5 T the effects on liver and spleen signal intensity of 5, 15, and 45 mumol/kg body weight of dextran magnetite (SHU 555A) in 54 rats. Nine rats served as controls. At different time delays since injection, the animals were killed, and after perfusion with saline, the liver, brain, and spleen were fixed in formalin. The specimens were embedded in an agar gel matrix and imaged with inversion recovery T1-weighted, proton density spin echo, and T2*-weighted gradient recalled echo (GRE) sequences. At each magnetic field strength, peak liver and spleen signal loss increased with increasing dose of the contrast medium. Signal loss was significantly more conspicuous after a dose of 15 than 5 mumol/kg body weight, but not after a dose of 45 compared with 15 mumol/kg. No signal change was observed in the brain. GRE images showed higher enhancement than proton density-weighted spin echo and inversion recovery images but were noisier. The enhancement showed a plateau between 30 min and 24 hours. Only the signal decrease of the liver after a low dose of contrast medium on GRE images was significantly higher (p < 0.01) at 1.5 than at 0.5 and 0.3 T. Other differences in respect to the field strength were less significant (p < 0.05) or nonsignificant. Differences in the spleen enhancement were nonsignificant. SHU 555A at a dose of 15 mumol/kg is an efficient intracellular contrast agent for liver and spleen at low, mid, and high field strength. Proton density spin echo images are probably the sequence of choice to exploit SHU 555A contrast effects and a wide time window for imaging after its intravenous injection does exist.     

Serum levels of interleukin-6 as a prognostic factor in advanced non-small cell lung cancer

OBJECTIVE: The purpose of this study was to evaluate pancreatic enhancement with low-dose mangafodipir trisodium (5 mumol/kg) using three different T1-weighted pulse sequences. SUBJECTS AND METHODS: Fifteen patients, six of whom had proven focal pancreatic tumors, underwent T1-weighted gradient-recalled echo imaging, spin-echo imaging, and fat-suppressed spin-echo imaging before and 30 min after injection of 5 mumol/kg of mangafodipir trisodium. Region-of-interest measurements were obtained in the pancreas before and after contrast enhancement. Signal-to-noise ratios were calculated in all 15 patients. Contrast-to-noise ratios were calculated in the six patients with pancreatic tumors. RESULTS: The signal-to-noise ratios of the pancreas increased after injection of mangafodipir trisodium on all three T1-weighted pulse sequences (p < .001). Enhanced fat-suppressed sequences (29 +/- 7.7) and gradient-recalled echo sequences (29 +/- 9.6) had the highest signal-to-noise ratios. Contrast-to-noise ratios between normal pancreatic tissue and pancreatic tumor also increased after contrast administration (p < .05) and were highest on the fat-suppressed (-9.6 +/- 4.0) pulse sequence. CONCLUSION: Mangafodipir trisodium produced marked pancreatic enhancement at a dose of 5 mumol/kg for all three T1-weighted pulse sequences. The enhanced T1-weighted spin-echo fat-suppressed sequence showed the highest signal-to-noise and contrast-to-noise ratios.     

Enhancement efficacy of magnetic starch microshperes (MSM) in conventional spin-echo and turbo spin-echo sequences at 0.5 T and 1.5 T

The efficacy of the superparamagnetic contrast agent magnetic starch microspheres (MSM) was evaluated in vitro by NMR relaxometry and in vivo by MR imaging using T2-weighted spin-echo (SE) and turbo spin-echo (TSE) sequences at 0.5 T and 1.5 T in 60 normal rats who received MSM in doses of 10-50 mu mol/kg. MR imaging was performed using T2-weighted SE and TSE sequences. The relaxation rates 1/T1 and 1/T2 for liver and spleen increased linearly with MSM concentrations up to 30 mu mol/kg body weight, and approached almost constant levels for higher doses. The slopes in the linear part of the 1/T2 diagram were 0.62 Hz +/- 0.03 for the liver and 0.51 Hz +/- 0.06 x kg/mu mol for the spleen. On all T2-weighted sequences at 0.5 T and 1.5 T, liver signal-to-noise ratio (SNR) decreased by a factor of 2-3 already at the lowest dose of 10 mu mol/kg. SNR values of TSE sequences exceeded values for SE sequences by 50-80%. The SNR decrease was not significantly different between SE and TSE sequences. Our results show that MSM is well suited as a T2 contrast agent at both magnetic field strengths when using conventional SE and fast TSE sequences.     

Isolated lumbar strengthening in the rehabilitation of chronic low back pain

The purpose of this work is to describe our initial clinical experience (in 66 patients) with Resovist and Eovist, two new liver-specific MR contrast agents. We focus our report on safety aspects, dose finding, and optimization and technical parameters. Both contrast agents were well tolerated and improved the detectability of focal liver lesions. With Resovist, postcontrast MRI may be started as early as 10 min following injection. The dose of 8 mumol Fe/kg bodyweight was sufficient to achieve diagnostic tumor-liver contrast levels. Since Eovist can also be administered as a bolus, dynamic enhancement patterns may be studied for tumor characterization as well. Breath-hold T1-weighted FLASH images were superior to other T1-weighted techniques with and without fat saturation.     

Malignant lesions of the liver identified on T1- but not T2-weighted MR images at 1.5 T

The authors reviewed their 2 1/2-year experience with a magnetic resonance (MR) imaging protocol for a 1.5-T MR imager that included T2-weighted fat-suppressed spin-echo, T1-weighted breath-hold gradient-echo, and serial dynamic gadolinium-enhanced T1-weighted gradient-echo imaging to identify histologic types of malignant liver lesions more apparent on T1- than on T2-weighted images. MR images of 212 consecutive patients with malignant liver lesions were reviewed. T2-weighted, T1-weighted, and dynamic contrast-enhanced T1-weighted images were examined separately in a blinded fashion. Seven patients demonstrated liver lesions (lymphoma [two patients] and carcinoid, hepatocellular carcinoma, colon adenocarcinoma, transitional cell carcinoma, and melanoma [one patient each]) on T1-weighted images that were inconspicuous on T2-weighted images. In all cases, the lesions were most conspicuous on T1-weighted images obtained immediately after administration of contrast agent. Histologic confirmation was present for all seven patients. The consistent feature among these lesions was that they were hypovascular, due either to a fibrous stroma or to dense monoclonal cellularity. These results suggest that in some patients with hypovascular primary neoplasms, the lesions may be identified only on T1-weighted images, and that immediate postcontrast T1-weighted images are of particular value in demonstrating lesions.     

Magnetic resonance imaging of focal liver lesions. Comparison of the superparamagnetic iron oxide resovist versus gadolinium-DTPA in the same patient

RATIONALE AND OBJECTIVES: The authors assess the efficacy of static and dynamic magnetic resonance (MR) imaging using the superparamagnetic iron oxide SHU-555A (Resovist) versus standard dose of gadolinium (Gd)-DTPA in patients with focal liver lesions. METHODS: Magnetic resonance imaging was performed in 30 patients suffering from histopathologically verified malignant (n = 22) and benign (n = 8) liver lesions. T2-weighted conventional and fat-suppressed as well as T1-weighted sequences were used before, during, and after fast intravenous administration of Resovist (1 mL/minute) at three doses of 4, 8, and 16 mumol/kg body weight. One week before the Resovist-enhanced MR imaging study 20 patients underwent Gd-DTPA-enhanced MR imaging. RESULTS: Detection rate was improved for metastatic lesions revealing 36 lesions unenhanced versus 53 focal lesions using Resovist-enhanced MR imaging. Gadolinium-DTPA-enhanced scans showed no additional lesion versus unenhanced and Resovist-enhanced MR imaging. Static and dynamic imaging demonstrated no measurable percentage signal intensity loss (PSIL) using Resovist-enhanced MR imaging versus a percentage enhancement of 79.7% in Gd-DTPA enhanced scans. In the dynamic T2-weighted sequences, hepatocellular carcinoma nodules (n = 4) showed a rapid decrease in signal intensity starting at 44 seconds. Postinfusion of Resovist followed by a low, constant increase in signal intensity. Gadolinium-DTPA enhanced scans showed a percentage enhancement of 73.4 focal nodular hyperplasia (FNH) and hemangioma revealed a strong and early dose-dependent PSIL 44 to 60 seconds postinfusion with a prolonged signal loss for the FNH in the late study. Statistical evaluation revealed a statistically significant superiority of Resovist-enhanced MR imaging concerning the detection and delineation of focal liver lesions compared with unenhanced and Gd-DTPA enhanced scans (P < 0.05). CONCLUSIONS: The fast infusion of the new superparamagnetic contrast agent Resovist shows advantages for dynamic and static MR imaging of focal liver lesions.     

Gadobenate dimeglumine (BOPTA) enhanced MR imaging: patterns of enhancement in normal liver and cirrhosis

To determine whether gadobenate dimeglumine (BOPTA) will adequately enhance cirrhotic liver parenchyma, and to document the enhancement patterns in cirrhosis, 14 cirrhotic and 20 non-cirrhotic patients were evaluated before and 60-120 minutes after gadolinium-BOPTA. Proof of liver cirrhosis was biopsy (6), surgical resection (3), and clinical follow-up (5). Enhancement effects were compared quantitatively by determining the liver signal-to-noise ratio (SNR) and signal enhancement in both populations. Qualitatively assessment of the liver enhancement was performed and classified as homogeneous or heterogeneous. Quantitative analysis: cirrhotic liver parenchyma presented a higher increase in SNR values, relative to non-cirrhotic liver parenchyma, on postcontrast images. Likewise the signal enhancement of cirrhotic liver parenchyma was superior to non-cirrhotic liver on T1-weighted SE images (P = .02) and in-phase GRE images (P < .001). There was no statistical difference on out-of-phase GRE images. Qualitative analysis: on T1-weighted SE postcontrast images, cirrhotic liver parenchyma showed a homogeneous enhancement in 7 patients and heterogeneous in 7. Whereas on GRE images, cirrhotic parenchyma showed heterogeneous enhancement in 9 patients and homogeneous in 5 patients. The heterogeneous enhancement was due to the presence of hypointense nodules in 7 patients and hyperintense nodules in 2 patients. In conclusion, our study has shown that the hepatobiliary contrast agent Gd-BOPTA is effective in the cirrhotic liver, demonstrating an increased liver enhancement compared with non-cirrhotic patients.     

Mn-DPDP enhanced MRI in experimental bile duct obstruction

To assess both the effect of Mn-DPDP as a hepatobiliary-specific contrast agent in bile duct obstruction and the relative role of liver and kidney in the elimination of this agent from the body, an animal experiment was set up. Twelve rats were used and divided into three groups. In group 1 the common bile duct was ligated, in group 2 bile duct ligation was limited to one lobe, and group 3 served as control. Magnetic resonance T1-weighted SE images were obtained before and after the injection of 25 mumol/kg of Mn-DPDP during the first 2 h and at day 1, 2, 3, 4, and, in some animals, up to 21 days. In normal rats the absolute enhancement signal-to-noise ratio (S/N) versus time plots obtained from the liver after Mn-DPDP injection returned to precontrast values within 24 h. In the group with common bile duct ligation, important liver enhancement persisted up to 21 days. In the group with selective obstruction, liver intensity normalized after 3 days. The S/N plots from spleen, renal cortex, and obstructed liver lobe showed similarities in time course. The present data indicate that Mn elimination is strongly impaired in the presence of bile duct obstruction. Renal glomerular filtration is ineffective in eliminating Mn from the body. The persisting splenic and renal cortical enhancement suggests that free Mn or some Mn-DPDP metabolite either is strongly bound to plasma proteins and acts as a blood pooling agent and/or is uptaken by the splenic or renal parenchyma.     

Fast and ultrafast magnetic resonance imaging in renal lesions

Our purpose was to analyze and compare the image quality and contrast-to-noise ratio (CNR) of different fast T1- and T2-weighted sequences with conventional spin-echo sequences in renal MRI. Twenty-three patients with focal renal lesions were examined with a T2-weighted ultrafast turbo spin-echo (UTSE) sequence with and without frequency selective fat suppression (SPIR), a combined gradient-and-spin-echo sequence (GraSE), and a conventional spin-echo sequence (SE). In addition, T1-weighted images were obtained pre- and postcontrast, using a fast spin-echo sequence (TSE) with and without SPIR and the conventional SE sequence. Among the T2-weighted images, the highest CNR and the best image quality were obtained with the UTSE sequence, followed by the fat-suppressed UTSE sequence. GraSE and conventional SE sequences showed a significantly lower CNR and image quality (p < 0.05). The T1-weighted sequences did not show significant differences, in either precontrast or postcontrast measurements. T2-weighted UTSE with and without fat suppression combined excellent image quality and high CNR for imaging and detection of renal lesions. The T1-weighted fast sequences provided no alternative to the gradient-echo or to the conventional SE sequences. The results of this systematic study suggest the use of T2-weighted fast techniques for improved diagnostic accuracy of renal MRI.     

Macroscopic tumor volume of malignant glioma determined by contrast-enhanced magnetic resonance imaging with and without magnetization transfer contrast

The purposes of this study were to compare the conspicuity and lesion volume of contrast-enhancing macroscopic malignant glioma determined by postcontrast magnetic resonance (MR) imaging with and without magnetization transfer (MT) saturation, and to discuss possible implications for radiotherapy planning. Nineteen patients (age 24-60 years) with histologically proven malignant glioma were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight), the lesions were imaged with an MT-weighted FLASH (fast, low-angle shot) pulse sequence and with a conventional T1-weighted spin-echo (SE) sequence without MT saturation. The mean tumor volumes of gliomas measured on MT-weighted FLASH images were significantly (p < .01) larger than those obtained from T1-weighted SE images (45 +/- 15 cm3 vs. 33 +/- 10 cm3). The mean contrast-to-noise ratio of enhancing lesions on MT-weighted FLASH was 48 +/- 14 compared with 30 +/- 14 on SE images, representing a significant (p < .01) improvement. We conclude that the volume of contrast enhancement of malignant glioma identified on MT-weighted FLASH images represents the area of disrupted blood-brain barrier. If this volume of subtle contrast enhancement is caused by tumor infiltration and represents the boost target volume for stereotactic radiosurgery or brachytherapy, MT-weighted FLASH images would be better than T1-weighted SE images to define these volumes. These improved delineation of areas at highest risk for recurrence following radiation therapy should enhance the efficacy of treatment planning for high-boost therapy.     

Preoperative staging of endometrial carcinoma: diagnostic effect of T2-weighted fast spin-echo MR imaging

PURPOSE: To evaluate the usefulness of T2-weighted fast spin-echo magnetic resonance (MR) imaging with a 512 x 256 matrix for assessment of the preoperative stage of endometrial carcinoma. MATERIALS AND METHODS: Twenty-eight women with histopathologically proved endometrial carcinoma underwent preoperative T2-weighted fast spin-echo, dynamic T1-weighted fast spin-echo, and postcontrast T1-weighted spin-echo MR imaging with a phased-array surface coil. The uterine long-axis planes in each sequence were reviewed at separate sessions by three radiologists blinded to the histopathologic data. RESULTS: For the diagnosis of myometrial invasion, no statistically significant differences were found among T2-weighted imaging, dynamic imaging, and postcontrast T1-weighted imaging. For the diagnosis of deep myometrial invasion, T2-weighted and dynamic images showed higher specificity than postcontrast T1-weighted images (T2-weighted, 89%; dynamic, 88%; and postcontrast T1-weighted, 80%). For cervical invasion, T2-weighted and dynamic images showed larger areas under receiver operating characteristic curves than did postcontrast T1-weighted images (T2-weighted, 0.78; dynamic, 0.71; and postcontrast T1-weighted, 0.67). CONCLUSION: T2-weighted imaging is useful for identifying the stage of endometrial carcinoma.     

MnPcS4: a new MRI contrast enhancing agent for tumor localisation in mice

Manganese-tetrasulfonated phthalocyanine (MnPcS4) has been evaluated as a potential contrast agent in Magnetic resonance imaging (MRI) for tumor localisation in mice. MnPcS4 showed favourable molar relaxivity, much better than Gd-DTPA and comparable to tetrasulfonated manganese complex of porphyrin (TPPS4). Tumors showed selective retention of the metal complex (dye) with the peak value reached at 24 hours following intravenous administration. Dye concentration in tumors remained consistently higher than either kidney or muscle tissue both at 1 and 24 hours and a 10-fold increase in tumor-to-muscle ratio over the control was seen at 24 hr. Normal liver tissue, however, showed higher concentration than tumor at all times during the study. A linear correlation was found between longitudinal relaxation rate (1/T1) and the corresponding concentration of MnPcS4 in various tissues. MR imaging done in animals using 1.5 T superconducting clinical imager showed a mean percent increase in signal intensity of 131.8% (SD +/- 32.86) in the tumor and a 70% increase in tumor-to-muscle ratio over the pretreatment value, at 24 hr. The results suggest that MnPcS4 is a potential tumor-selective contrast agent in MRI.     

Focal malignant hepatic lesions: MR imaging enhanced with gadolinium benzyloxypropionictetra-acetate (BOPTA)--preliminary results of phase II clinical application

PURPOSE: To investigate enhancement with gadolinium benzyloxypropionictetraacetate (BOPTA) at magnetic resonance (MR) imaging to detect focal malignant hepatic lesions. MATERIALS AND METHODS: A phase II trial was performed in 34 patients. Gd-BOPTA-enhanced spin-echo (SE) and gradient-recalled-echo (GRE) T1-weighted MR imaging were performed at 40 and 90 minutes after intravenous injection of 0.05 and 0.10 mmol/kg Gd-BOPTA. RESULTS: The percentage of enhancement in liver parenchyma was significantly (P<.05) increased on GRE T1-weighted compared with SE T1-weighted images at 40 and 90 minutes after injection of the higher dose and compared with SE and GRE T1-weighted images obtained with the lower dose. The contrast-to-noise ratio of metastases was significantly increased on GRE T1-weighted images (0.10 mmol/kg) at 90 minutes compared with precontrast images. Significantly more small primary metastases were detected on GRE T1-weighted images (0.10 mmol/kg) at 90 minutes compared with precontrast SE T1-weighted images. CONCLUSION: Gd-BOPTA is a safe hepatobiliary contrast agent that helps detection of small metastases.     

Sympatholytic action of intravenous amiodarone in the rat heart

BACKGROUND: Amiodarone is a commonly used antiarrhythmic agent with complex pharmacological effects. Although ventricular arrhythmias can be suppressed soon after intravenous amiodarone, the mechanisms responsible for this action are unclear. We studied the effects of acute treatment with amiodarone on the metabolism and release of norepinephrine (NE) in intact rats and in perfused rat hearts. METHODS AND RESULTS: Experiments were performed in anesthetized rats and in perfused, innervated hearts with amiodarone administered intravascularly. NE release was induced by electrical stimulation of the sympathetic ganglion. Concentrations of NE and its intraneuronal metabolite dihydroxyphenylglycol (DHPG) in hearts, plasma, and coronary venous effluent were measured by high-performance liquid chromatography. Acute administration of amiodarone induced dose-dependent increases in DHPG concentrations in plasma (5 mg/kg, +48%; 15 mg/kg, +84%; and 50 mg/kg, +467%) and in coronary venous effluent (1 mumol/L, +37%; 3 mumol/L, +510%; and 10 mumol/L, +1100%) together with an unchanged basal overflow of NE. In perfused hearts, NE release evoked by nerve stimulation was inhibited by infusion of amiodarone (1 mumol/L, -16%; 3 mumol/L, -24%; and 10 mumol/L, -64%) or by intravenous amiodarone (50 mg/kg) given 1 hour before heart perfusion (-70%), and the extent of this suppression correlated well with levels of DHPG overflow present immediately before nerve stimulation. When given in vitro and in vivo, amiodarone also significantly reduced NE and increased DHPG content in the heart, leading to a raised DHPG/NE ratio. All these effects of amiodarone were similar to those found with reserpine but less potent. In contrast, oral amiodarone produced none of these effects. CONCLUSIONS: Acute administration of amiodarone in perfused hearts or intact rats induces partial NE depletion in the heart by interfering with vesicular NE storage and enhancing intraneuronal NE metabolism, effects associated with an impaired NE release during sympathetic activation. Oral dosing with amiodarone has no such effect. Further study is required to test whether this novel sympatholytic effect of amiodarone contributes to its antiarrhythmic action after intravenous administration.     

A comparison of two MR hepatobiliary gadolinium chelates: Gd-BOPTA and Gd-EOB-DTPA

PURPOSE: Two gadolinium chelates with partial hepatobiliary excretion, Gd-BOPTA and Gd-EOB-DTPA, and one gadolinium chelate with exclusively renal excretion, Gd-HP-DO3A, were compared on MRI at 1.5 T. The time course of enhancement for normal liver, gallbladder, spleen, kidney, and muscle was specifically examined in the rhesus monkey. METHOD: Four animals were evaluated with each agent for a total of 12 MR studies. Breath-hold and non-breath-hold T1 weighted scans were acquired prior to and 1, 2, 3, 4, 5, 15, 30, 45, 60, 75, and 90 min after intravenous contrast medium injection. The same contrast dose, 0.1 mmol/kg, was used for all studies. Images were analyzed by region-of interest measurements. RESULTS: Both hepatobiliary gadolinium chelates achieved sustained enhancement of normal liver parenchyma, superior in magnitude to that following Gd-HP-DO3A injection. On sans 45-90 min following injection, liver enhancement with Gd-BOPTA was superior to that with Gd-EOB-DTPA. This difference was, however, not statistically significant. Liver enhancement decreased more rapidly on delayed scans with Gd-EOB-DTPA than with Gd-Bopta, a result that was statistically significant. Excretion of contrast agent into the gallbladder was noted with both hepatobiliary agents but not with Gd-HP-DO3A. CONCLUSION: Enhancement of normal liver parenchyma peaks at a later time after injection with Gd-BOPTA than with Gd-EOB-DTPA. However, the maximum percent enhancement is comparable when (as in the current evaluation) the two agents are compared at the same dose (0.1 mmol/kg). This finding supports the choice of optimal imaging time post contrast agent administration (for delayed scans) in clinical trials of 20-45 min post injection with Gd-EOB-DTPA and 60-120 min post injection with Gd-BOPTA.     

Organ preservation in locally advanced carcinoma of the uterine cervix

The purpose of this study was to demonstrate the potential usefulness of the combination of gadolinium and dysprosium to enhance the different between normal and necrotic liver tissue. Small regions of acute necrosis were induced by injecting 200-300 microliters of 95% alcohol into the liver of 26 rats. MRI was performed 24 hours after necrosis induction, before and immediately after injection of one or both contrast agents. Using a mixed T1/T2-weighted sequence, the signal intensity of (SI) of the normal liver was reduced by 70%, whereas the necrotic regions had more than a 50% increase in SI after double contrast. The region that was enhanced corresponded largely with the region of necrosis as observed postmortem. The lesion size, when identified, was largely underestimated using either of the agents along, albeit using the common pulse sequences. The double contrast effect of simultaneous administration of gadolinium and dysprosium allows accurate delineation of liver necrosis.     

Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials

Nodular hepatocellular carcinoma (HCC) is characterized by the presence of a pseudocapsule (constructed usually from connective fibrous tissue) that appears hypointense on T1- and T2-weighted spin-echo (SE) and gradient-echo (GE) MR imaging sequences without a contrast medium. The presence of vascular structures inside the tumor, which are verified by histological exam, affects enhancement of the PC after administrating the contrast medium: The impregnation is more evident in the dynamic study but also persists on the delayed T1-weighted SE images. The accuracy of MR in detecting the pseudocapsule of HCC and contrast enhancement of the pseudocapsule during dynamic studies were evaluated and related to pathological findings. Thirty-seven HCC were examined in 33 patients and afterwards resected. In capsulated nodules, besides usual hematoxylin, eosin, and trichrome stainings, histochemical and immunohistochemical methods were performed. On a 1.5-T MR unit, T1- and T2-weighted SE and GE FLASH 2D sequences after intravenous injection of Gd-DTPA (dynamic study) were used. In a later phase, T1-weighted SE sequences were repeated. Histologically, the pseudocapsule (thickness 0.2-6 mm) was present in 26 of 37 nodules (70%). The dynamic study was the most suitable technique to show the pseudocapsule, which was recognized in 80.7% (21 of 26 nodules). In 5 of 26 cases, the pseudocapsule, not demonstrated by MR, was thinner than 0.4 mm. In 16 of 21 cases, in the early portal phase (30-60 s), the pseudocapsule had an early enhancement, which was more evident later; in 5 of 21 cases the enhancement was observed only in the late portal phase (1-2 min). At histological examination, 14 of 16 pseudocapsules with early enhancement showed a more prominent vasculature than those with enhancement in the equilibrium phase. Magnetic resonance was a reliable tool in demonstrating the pseudocapsule of HCC. The histological examination demonstrated a good correlation between the enhancement behavior and the vessel number of the pseudocapsule.     

Severe right ventricular dysfunction in a neonate with aortic origin of the RPA

A 77-year-old man had rapidly increased intramuscular tuberculous abscess in his left buttock. Radiographs showed a bone defect in the left ischium. Postcontrast CT scanning revealed marginal enhancement. MR imaging showed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. T1-weighted MR images with Gd-DTPA enhancement showed enhancement of the wall. Bone defect and marginal enhancement on postcontrast MR images and on postcontrast CT images are image character of the intramuscular tuberculous abscess.     

Fat-suppressing STIR sequences with and without contrast media in the MRT of ENT tumors

Fat-suppressed STIR (short TI inversion recovery) sequences were compared to plain and contrast-enhanced T1-weighted SE sequences of head and neck tumors. 19 patients underwent MR imaging on a 0.5 Telsa system (T5-II, Philips). STIR imaging parameters: TR/TE = 1000/20 ms, inversion pulse 100 ms. All films were read by four radiologists. The image quality was graded: score from 0 to 5, by means that grade 5 = optimal quality. Sensitivity was 89% in STIR, 96% in SE sequences. Tumor delineation was graded good in the enhanced T1-weighted and enhanced fat suppression images. The unenhanced imaging was superior in STIR (STIR/T1 = 2.8/2.43). The tumor contrast was best in contrast enhanced and plain STIR sequences (STIR contrast = 3.41), and in the contrast enhanced T1-weighted SE (3.33). STIR almost equaled T1 post-contrast in respect of tumour conspicuity, but the sensitivity was lower. STIR can be a supplement to SE, but cannot substitute T1 postcontrast. The combined use is expected to have the highest assessment value.     

Pharmacokinetics and metabolic disposition of 14C-metronidazole-derived radioactivity in rat after intravenous and intravaginal administration

Urinary metabolites and the pharmacokinetics of radioactivity derived from 14C-metronidazole (14C-MTZ) were determined after intravenous (iv) or intravaginal (ivg) administration of 10 mg/kg to adult rats. Following iv or ivg administration, the disappearance of 14C from blood followed the kinetics of a two-compartment open-system model. The blood half-lives of 14C during the beta-phase were 10.9 +/- 1.6 and 13.6 +/- 4.2 hr, after iv and ivg administration, respectively. After ivg application, the MTZ-derived radioactivity was detected in tail blood at 5 min, peaked at 1 hr, declined rapidly to 6 hr and more slowly thereafter. The vaginal absorption half-life of 14C-MTZ was 0.28 +/- 0.09 hr. About 12% of the administered dose remained in the vagina after 1 hr and 1.5% after 24 hr. At 24 hr, the tissue distribution and concentration of 14C were similar in iv and ivg dosed rats, the highest 14C concentration being present in the kidneys and lowest in the fat. The percentages of the dose excreted in 24 hr in the urine and feces were 58 and 15 after iv administration, compared to 37 and 40 after the ivg route, respectively. Unchanged 14C-MTZ and five of its metabolites were detected in the urine irrespective of the route of administration. The results show that metronidazole is rapidly absorbed through the vaginal mucosa of the rat and the metabolism and excretion of this chemotherapeutic agent are influenced by the route of administration.