Document Detail


Recurrent inverted papilloma: diagnosis with pharmacokinetic dynamic gadolinium-enhanced MR imaging.
MedLine Citation:
PMID:  10512227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  20     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-11-19     Completed Date:  1999-11-19     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1445-51     Citation Subset:  IM    
Affiliation:
Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Taiwan, ROC, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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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