Ces radiol. 2009, 63(4):315-321

Steady-state gadofosveset-enhanced dark lumen MR-enterographyOriginal article

Jiří Ferda1, Hynek Mirka1, Jana Koželuhova2, Jan Kastner4, Jan Baxa1, Eva Ferdová1, Ondřej Daum1, Vladislav Třeška3, Boris Kreuzberg1
1 Department of Imaging Methods, Charles University Teaching Hospital Plzen and Medical Faculty Plzen
2 Department of Internal Medicine, Charles University Teaching Hospital Plzen and Medical Faculty Plzen
3 Šikl's Institute of Pathological Anatomy, Charles University Teaching Hospital Plzen and Medical Faculty Plzen
4 Department of Surgery, Charles University Teaching Hospital Plzen and Medical Faculty Plzen

Aim: To evaluate the feasibility dark lumen MR enterography (MRE) employing the gadofosveset-enhanced steady-state phase in the assessments of Crohn's disease (CD) activity.

Method: 50 patients with proved CD (28 pt. with CD activity index 150 and more) underwent MRE after intravenous administration of the blood-pool agent gadofosveset. MRE was performed after oral bowel preparation with 2.5% mannitol. Gradient echo T1 weighted images were obtained without intravenous contrast application, than in first-pass dynamic phase after application of gadofosveset in arterial, early-portal and late-portal phases. Additional images were performed after ten minutes after actual beginning of the intravenous injection during blood-pool steady-state distribution of gadofosveset. If the bowel wall enhancement was occurred, the lasting and the changes of the enhancement pattern through all phases were evaluated.

Results: Lasting 10 minutes and more, the layered retained enhancement was detected in 26 of 28 patients. Only in 2 of cases with CDAI more than 150, homogeneous bowel wall enhancement was present on delayed images. The sensitivity of the layered retained enhancement as a sign of CD activity was 92.9% (26/28); specificity was 95.5% (21/22) respectively.

Conclusion: Thanks to its blood-pool distribution, gadofosveset could be used as the targeting contrast agent of the hypervascularized inflammatory tissue in patients with active Crohn disease. Layered bowel wall enhancement remained more than 10 minutes was well correlated with clinical sign of the CD activity.

Keywords: MR-enterography, Crohn's disease, blood-pool contrast agent, gadofosveset

Accepted: May 15, 2009; Published: December 1, 2009  Show citation

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Ferda J, Mirka H, Koželuhova J, Kastner J, Baxa J, Ferdová E, et al.. Steady-state gadofosveset-enhanced dark lumen MR-enterography. Ces radiol. 2009;63(4):315-321.
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