| Recurrent inverted papilloma: diagnosis with pharmacokinetic dynamic gadolinium-enhanced MR imaging. | |
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MedLine Citation:
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PMID: 10512227 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Dynamic gadolinium-enhanced MR imaging has been used successfully to identify post-treatment recurrence or postoperative changes in rectal and cervical carcinoma. Our purpose was to evaluate the usefulness of dynamic gadolinium-enhanced MR imaging for distinguishing recurrent inverted papilloma (IP) from postoperative changes. METHODS: Fifteen patients with 20 pathologically proved lesions (recurrent IP, 12; fibrosis or granulation tissue, eight) were enrolled in the study. Three observers, blinded to pathologic results, independently evaluated conventional MR images, including T1-weighted (unenhanced and postcontrast), proton-density-weighted, and T2-weighted spin-echo images. Results then were determined by consensus. Dynamic images were obtained using fast spin-echo sequences at 5, 30, 60, 90, 120, 150, 180, and 300 seconds after the injection of gadolinium-diethylene-triamine penta-acetic acid. Time-signal intensity curves of suspected lesions were analyzed by a pharmacokinetic model. The calculated amplitude and tissue distribution time were used to characterize tissue, and their values were displayed as a color-coded overlay. RESULTS: T2-weighted images yielded a sensitivity of 67%, a specificity of 75%, and an accuracy of 70% in the diagnosis of recurrent IP. Contrast-enhanced T1-weighted images yielded a sensitivity of 75%, a specificity of 50%, and an accuracy of 65%. Pharmacokinetic analysis showed that recurrent IP had faster (distribution time, 41 versus 88 seconds) and higher (amplitude, 2.4 versus 1.2 arbitrary units) enhancement than did fibrosis or granulation tissue. A cut-off of 65 seconds for distribution time and 1.6 units for amplitude yielded a sensitivity of 100% and a specificity of 100% for diagnosing recurrent IP. CONCLUSION: Dynamic MR imaging can differentiate accurately recurrent IP from postoperative changes and seems to be a valuable diagnostic tool. |
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Authors:
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P H Lai; C F Yang; H B Pan; M T Wu; S T Chu; L P Ger; W C Huang; C C Hsu; C N Lee |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: AJNR. American journal of neuroradiology Volume: 20 ISSN: 0195-6108 ISO Abbreviation: AJNR Am J Neuroradiol Publication Date: 1999 Sep |
Date Detail:
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Created Date: 1999-11-19 Completed Date: 1999-11-19 Revised Date: 2008-02-14 |
Medline Journal Info:
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Nlm Unique ID: 8003708 Medline TA: AJNR Am J Neuroradiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1445-51 Citation Subset: IM |
Affiliation:
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Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Taiwan, ROC, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Contrast Media / pharmacokinetics* Diagnosis, Differential Female Gadolinium DTPA / diagnostic use, pharmacokinetics* Humans Image Enhancement* Image Processing, Computer-Assisted Magnetic Resonance Imaging* Male Middle Aged Neoplasm Recurrence, Local / diagnosis*, pathology, surgery Nose / pathology, surgery Nose Neoplasms / diagnosis*, pathology, surgery Papilloma, Inverted / diagnosis*, pathology, surgery Paranasal Sinus Neoplasms / diagnosis*, pathology, surgery Paranasal Sinuses / pathology, surgery Postoperative Complications / diagnosis*, pathology, surgery Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 80529-93-7/Gadolinium DTPA |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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