Cirrhosis of the liver: MR imaging with mangafodipir trisodium (Mn-DPDP).

Murakami, Takamichi; Baron, Richard L.; Federle, Michael P.; Peterson, Mark S.; Oliver, James H.; Davis, P L; Confer, S R

doi:10.1148/radiology.198.2.8596867

Cited by 38 publications

(30 citation statements)

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“…In phase-3 trials, enhancement of the parenchyma in patients with liver cirrhosis has been found, although it was significantly less in patients without cirrhosis [49,50]. HCC may contain a variable amount of functioning hepatocytes.…”

Section: Hccmentioning

confidence: 99%

Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications

2004

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Hepatobiliary contrast agents with uptake into hepatocytes followed by variable biliary excretion represent a unique class of cell-specific MR contrast agents. Two hepatobiliary contrast agents, mangafodipir trisodium and gadobenate dimeglumine, are already clinically approved. A third hepatobiliary contrast agent, Gd-EOB-DTPA, is under consideration. The purpose of this review is to provide an overview on the properties, clinical development and application of these three hepatobiliary contrast agents. Bolus injectable paramagnetic hepatobiliary contrast agents combine established features of extracellular agents with the advantages of hepatocyte specificity. The detection and characterisation of focal liver disease appears to be improved compared to unenhanced MRI, MRI with unspecific contrast agents and contrast-enhanced CT. To decrease the total time spent by a patient in the MR scanner, it is advisable to administer the agent immediately after acquisition of unenhanced T1-w MRI. After infusion or bolus injection (with dynamic FS-T1-w 2D or 3D GRE) of the contrast agent, moderately and heavily T2w images are acquired. Post-contrast T1-w MRI is started upon completion of T2-w MRI for mangafodipir trisodium and Gd-EOB-DTPA as early as 20 min following injection, while gadobenate dimeglumine scans are obtained >60 min following injection. Post-contrast acquisition techniques with near isotropic 3D pulse sequences with fat saturation parallel the technical progress made by MSCT combined with an unparalleled improvement in tumour-liver contrast. The individual decision that hepatobiliary contrast agent one uses is partly based on personal preferences. No comparative studies have been conducted comparing the advantages or disadvantages of all three agents directly against each other.

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Section: Hccmentioning

confidence: 99%

Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications

2004

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“…24 In patients, cirrhosis also is associated with a low SI enhancement and the Child-Pugh index and the serum aspartate aminotransferase concentrations are related to the enhancement. 25,26 The enhancement is low in areas with fibrous tissues and higher in areas with regenerating nodules. 25,26 Increased enhancement in regenerating nodules, possibly due to impaired bile excretion, explains why enhancement of impaired liver parenchyma is higher in patients with hepatocarcinomas than the enhancement of normal liver parenchyma in patients with focal nodular hyperplasia.…”

Section: Gd-bopta Entry Into Hepatocytes During Cirrhosismentioning

confidence: 99%

Magnetic Resonance Imaging With Hepatospecific Contrast Agents in Cirrhotic Rat Livers

Planchamp¹,

Montet²,

Frossard³

et al. 2005

Investigative Radiology

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Objective: During biliary cirrhosis in rats, organic anion-transporting peptides (Oatps) and ATP-dependent multidrug resistance-associated protein 2 (Mrp2) that are likely to transport the contrast agent Gd-BOPTA through hepatocytes are down-regulated. However, the consequences of such down-regulation on the signal intensity (SI) enhancement are unknown. Consequently, the aim of our study was to measure the hepatic SI enhancement during Gd-BOPTA perfusion as well as the Oatp and Mrp2 expression in normal and cirrhotic livers. Materials and Methods:The hepatic SI enhancement during Gd-BOPTA perfusion was measured in livers isolated from normal rats and rats that had a bile duct ligation (BDL) 15, 30, and 60 days before the perfusion. Hepatic injury and transporter expression were measured in control and cirrhotic rats. Results: BDL induced a severe hepatic injury that increased over time with a down-regulation of the transporter expression. The extracellular space (assessed by Gd-DTPA perfusion) increased with the severity of the disease. Gd-BOPTA-induced SI enhancement remained similar in BDL-15 and BDL-30 rats than in control rats but significantly decreased in severe cirrhosis (BDL-60 rats). In comparison, the Mn-DPDP-induced SI enhancement decreases proportionally to the severity of the disease. Conclusion: During biliary cirrhosis, Gd-BOPTA-induced SI enhancement could not be related to the hepatic expression of transporters.

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“…MR imaging evaluation of the cirrhotic liver may be enhanced by the use of targeted MR contrast agents [47,48]. These agents differ from the extracellular gadolinium chelates in that they are incorporated into hepatic cells or phagocytized by Kupffer cells, and enhance the contrast between the liver parenchyma and the tumor without normal liver cell function nor Kupffer cells.…”

Section: Mr Imaging Of Hepatic Carcinoma Using Tissue-specific Contramentioning

confidence: 99%

“…These agents differ from the extracellular gadolinium chelates in that they are incorporated into hepatic cells or phagocytized by Kupffer cells, and enhance the contrast between the liver parenchyma and the tumor without normal liver cell function nor Kupffer cells. The liver-specific contrast media such as SPIO, which is absorbed into the reticuloendothelial system [49], and hepatobiliary contrast media gadoxetic acid disodium (Gd-EOB-DTPA), gadobenate dimeglumine (Gd-BOPTA), mangatodipir trisodium (Mn-DPDP), which are absorbed into the liver cells and excreted into the bile [48,50,51], can contrast a tumor with normal tissue by being absorbed in the liver parenchyma which has normal liver cell function, but not in the tumor which has no liver cell function.…”

Section: Mr Imaging Of Hepatic Carcinoma Using Tissue-specific Contramentioning

confidence: 99%

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Multidetector Row CT and MR Imaging in Diagnosing Hepatocellular Carcinoma

Murakami

Hori²,

Kim³

et al. 2004

Intervirology

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It is important to diagnose hepatocellular carcinoma (HCC) correctly and in early stage, because viral hepatitis and liver cirrhosis are often complicated by HCC. Noncontrast and enhanced CT and MRI are very useful to visualize and diagnose HCC objectively. Especially, CT and MR imaging with dynamic study is essential to diagnose HCC, because it is usually hypervascular. Dynamic CT and MR study also improve differential diagnosis in the characterization of the tumor. However, to perform useful dynamic study, it is necessary to use a CT unit which can make a helical scan, or a MR system with fast imaging technique available that can obtain more than 15 slices within a single breath hold. Tissue specific contrast medium, such as superparamagnetic iron oxide that is available only on MRI, is also useful for diagnosis of HCC.

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Cirrhosis of the liver: MR imaging with mangafodipir trisodium (Mn-DPDP).

Abstract: Mn-DPDP is useful in patients with cirrhosis.

Cited by 38 publications

References 0 publications

Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications

Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications

Magnetic Resonance Imaging With Hepatospecific Contrast Agents in Cirrhotic Rat Livers

Multidetector Row CT and MR Imaging in Diagnosing Hepatocellular Carcinoma

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