Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images

We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were examined by unenhanced and mangafodipir trisodium-enhanced MRI. After administration of mangafodipir trisodium by slow intravenous infusion, mangafodipir trisodium-enhanced MRI was performed at 15-30 min and 24 h. The enhancement appeared in normal liver parenchyma and all of the hepatocellular lesions (HCCs and FNH). The lesions in hepatocellular carcinomas patients showed a non-homogeneous enhancement pattern. Non-hepatocellular lesions (hemangiomas, metastases, CCCs) had no enhancement on mangafodipir trisodium-enhanced MRI examinations. The rim-like enhancement pattern was demonstrated in all patients with cholangiocellular carcinomas, and in 14 metastases and 11 hemangiomas. Mangafodipir trisodium-enhanced MRI permits reliable distinction between hepatocellular and non-hepatocellular tumors. Mangafodipir trisodium-enhanced MRI can show more functional and morphologic features of hepatocellular lesions. Some non-hepatocellular lesions which went undetected on unenhanced MRI were visualized after contrast enhancement of the liver. The rim-like enhancement pattern is not specific for metastases. Mangafodipir trisodium-enhanced MRI is safe and well tolerated and may aid in noninvasive diagnosis of liver lesions.