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European Radiology

, Volume 14, Issue 4, pp 559–578 | Cite as

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

  • Peter Reimer
  • Günter Schneider
  • Wolfgang Schima
Hepatobiliary-pancreas

Abstract

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.

Keywords

Gadobenate dimeglumine Mangafodipir trisodium Gd-EOB-DTPA Liver Detection Characterisation Classification Dynamic MRI 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Peter Reimer
    • 1
  • Günter Schneider
    • 2
  • Wolfgang Schima
    • 3
  1. 1.Department of RadiologyStädtisches Klinikum Karlsruhe, Academic Teaching Hospital of the University of FreiburgKarlsruheGermany
  2. 2.Department of Diagnostic RadiologyUniversity Hospital of SaarlandHomburg/SaarGermany
  3. 3.Department of RadiologyUniversity of ViennaViennaAustria

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