SPIOs and Low Molecular Weight Gd Chelates Are Synergistic for Direct Visualization of Advanced Liver Fibrosis
Chavez A, Bydder M, Julie C, Hughes F, Sirlin C, Tanya W, Znamirowski R, Behling C, Bydder G
Super-paramagnetic iron oxides (SPIO) and gadolinium (Gd) chelates increase visibility of liver fibrosis on MR imaging by different mechanisms. This study compared the visibility of advanced liver fibrosis on unenhanced, Gd-enhanced, SPIO-enhanced, and combined (SPIO + Gd) contrast-enhanced MR images. In 58 consecutive cirrhotic patients imaged with four different spoiled gradient recalled echo sequences, fibrosis-liver contrast to noise ratio was significantly higher with combined contrast enhancement than with SPIO or Gd alone, and was higher with SPIO or Gd than without any contrast enhancement. The results indicate that SPIO and Gd are synergistic for detecting advanced liver fibrosis.