Dynamic contrast-enhanced FMPSPGR of the pancreas: impact on diagnostic performance.

Abstract

The objective of this study was to evaluate the diagnostic impact of dynamic contrast-enhanced fast multiplanar spoiled gradient-recalled imaging (FMPSPGR) of the pancreas. MR imaging examinations of the upper abdomen for 101 patients were evaluated retrospectively and compared with histologic and surgical results as well as imaging or laboratory and clinical follow-up results. Standard T1-weighted spin-echo images, T2-weighted fast spin-echo images with fat saturation, and FMPSPGR had been obtained for all patients. Of the 101 patients, 79 also underwent fat-saturated contrast-enhanced T1-weighted spin-echo MR imaging. Qualitative analysis consisted of evaluation of overall image quality and characterization of the pancreas as normal or abnormal, for which receiver operating characteristic curves were calculated. A contrast-to-noise ratio between the pancreas and the surrounding tissue was calculated for each patient. By a statistically significant margin, FMPSPGR performed better than conventional spin-echo MR imaging. For FMPSPGR, sensitivity and specificity were 87% and 100%, respectively, compared with T1-weighted spin-echo sequences (sensitivity, 50%; specificity, 96%), T2-weighted spin-echo sequences with fat saturation (sensitivity, 60%; specificity, 93%), and contrast-enhanced T1-weighted spin-echo sequences with fat saturation (sensitivity, 53%; specificity, 90%). Diagnostic confidence was highest with FMPSPGR. FMPSPGR should be used in all MR imaging examinations of the upper abdomen. This technique offers better visualization of important structures and increases confidence for a more specific and accurate diagnosis than does conventional spin-echo imaging.