PERITONEAL TUMOR - MR-IMAGING WITH DILUTE ORAL BARIUM AND INTRAVENOUSGADOLINIUM-CONTAINING CONTRAST AGENTS COMPARED WITH UNENHANCED MR-IMAGING AND CT

PURPOSE: To compare fat-suppressed, gadolinium-enhanced, breath-hold m agnetic resonance (MR) imaging after administration of dilute oral bar ium solution with unenhanced MR imaging and computed tomography (CT) i n the detection of peritoneal tumors. MATERIALS AND METHODS: In 24 pat ients in whom peritoneal tumor was known or suspected, double-contrast MR imaging and CT were performed prospectively. MR imaging included T 1-weighted, fast spin-echo T2-weighted, and immediate and delayed gado linium-enhanced, breath-hold, fast multiplanar sequences with fat satu ration. Helical and conventional dynamic CT were performed with intrav enously and orally administered contrast media. MR images and CT scans were reviewed independently and prospectively by different pairs of r adiologists for presence of peritoneal tumor in 17 anatomic sites. Ima ging findings were compared with surgical and histopathologic results. RESULTS: Of the 24 patients, 18 had peritoneal tumor confirmed at sur gery. Detection of tumor sites was superior with double-contrast MR im ages (mean sensitivity, specificity, and accuracy, 84%, 87%, and 86%, respectively) compared with CT scans (mean sensitivity specificity, an d accuracy, 54%, 91%, and 74%, respectively). Double-contrast MR imagi ng enabled better detection of carcinomatosis and tumors less than 1 c m in diameter (75%-80%) than CT (22%-33%; P<.0001). CONCLUSION: Double -contrast MR imaging demonstrated more peritoneal tumors than CT or un enhanced spin-echo MR imaging.