Dual contrast magnetic resonance imaging with combined use of positive and negative contrast agent in human hepatocellular carcinoma

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Abstract
Dual contrast magnetic resonance imaging (DCMR) with combined use of a negative contrast medium, chondroitin sulfate iron colloid (CSIC), and a positive contrast medium, Gd-DTPA, was attempted in 20 cases of hepatocellular carcinoma. Spin echo T1 weighted and T2 weighted images (T1WI, T2WI), and T1 weighted images 15 min after intravenous injection of Gd-DTPA (0.1 mmol kg-1) were obtained. Within 1 week, these MR studies were repeated within 1 h of intravenous injection of CSIC (23.6 mumol Fe kg-1) under similar conditions. DCMR and the other five imaging techniques were visually evaluated and compared in terms of tumour detectability, tumour spread and qualification of tumours (depiction of inner structure). DCMR was significantly better than Gd-DTPA enhanced T1WI in tumour detectability, and better than Gd-DTPA enhanced T1WI or CSIC enhanced T1WI in depicting tumour spread. In the qualification of tumours, DCMR was significantly better than all the other five imaging techniques. None of the patients in this study showed adverse reactions or significant changes in biochemistry. DCMR is an imaging technique which is able to utilize the characteristics of these contrast agents collectively, and exhibits advantages in grasping the inner structure of tumours, especially in hepatocellular carcinoma.