MR-IMAGING ENHANCEMENT WITH SUPERPARAMAGNETIC IRON-OXIDE IN CHRONIC LIVER-DISEASE - INFLUENCE OF LIVER DYSFUNCTION AND PARENCHYMAL PATHOLOGY

Purpose: To analyze the influence of liver dysfunction and parenchymal pathology on the accumulation of superparamagnetic iron oxide (SPIO). Methods: We evaluated MR images of 13 patients having small hepatic n eoplasms before and after administration of SPIO (10 mu mol/kg). Biops y and laboratory data confirmed the presence of severe cirrhosis in tw o patients, mild cirrhosis in four, chronic hepatitis in five, and nor mal livers in two. Degrees of liver dysfunction or liver parenchymal p athology were correlated with reductions in signal intensity of the li ver and spleen after administration of SPIO. Signal intensity reductio n was evaluated using a 1.5 Tesla MR unit. Results: Response to SPIO o f the liver and spleen did not correlate with liver parenchymal pathol ogy, although reductions in signal intensity of the liver were somewha t small in severely cirrhotic livers. There were slight correlations b etween signal intensity alterations of the liver and laboratory data s uch as the indocyanine green retention rate (correlation coefficient 0 .47), albumin (0.36), total bilirubin (0.36), and serum glutamic oxalo acetic transaminase (GOT) (0.46). Signal intensity reduction of spleen did not correlate with liver function tests except for serum GOT, In patients with cirrhosis, heterogeneous structures were detected in the nontumorous portions of the liver. However, these did not prevent the diagnosis of small hepatomas. Conclusion: The uptake of SPIO showed s ome correlation with liver function but not with chronic liver parench ymal pathology. SPIO provided sufficient contrast between tumor and su rrounding liver parenchyma among patients with chronic liver disease.