DYNAMIC FAST-GRADIENT ECHO MR-IMAGING OF PANCREATIC TUMORS

The purpose of this study was to determine the diagnostic utility of d ynamic magnetic resonance imaging (MRI) of the pancreas. Twenty-eight adult patients with known or suspected pancreatic rumours were examine d. Pre- and post-gadolinium (GdDTPA-BMA) scans were obtained in combin ation with an oral negative contrast medium (ferristene) to mark the g astrointestinal tract. In 6 cases a more precise diagnosis could be ma de by dynamic MRI compared to unenhanced MRI. Surgery could confirm th e MR diagnosis based on contrast enhancement in 83% compared to 78% Fo r CT. The results of signal intensity (SI) measurements show that a co mbination of differences in baseline values before enhancement and the slope of enhancement within the first 20 s is a reliable criterion to distinguish between normal pancreas and hypovascular tumours. These t umours already show lower SI values before as well as lower slopes aft er early enhancement. Mainly two effects facilitate the final MRI diag nosis. (1) the delineation of the pancreas from the duodenum by the ne gative contrast medium, and (2) the enhancement pattern of pancreatic rumours by gadolinium-enhanced dynamic MRI compared to normal tissue w ithin the early enhancement after contrast injection. (C) 1997 Elsevie r Science Ireland Ltd.