iothalamate-meglumine and Hemangioma

The purpose of this study was to evaluate the sensitivity and specificity of globular enhancement for differentiating hepatic hemangiomas from hypervascular metastases on single-pass, contrast-enhanced CT scans. Globular enhancement was defined as enhancing nodules less than 1 cm seen within a lesion.. Fifty CT examinations were retrospectively evaluated in a blinded fashion by two independent reviewers. The CT studies were done with nonhelical technique after the IV injection of 150 ml of contrast material. The series included 25 patients with histologically proven hypervascular hepatic metastases (carcinoid, islet cell carcinoma, and leiomyosarcoma) and 25 patients with clinically proven hepatic hemangiomas. Patients with hemangiomas were clinically stable for at least 2 years after the CT studies. A single lesion was isolated from the first-pass, contrast-enhanced portion of each examination; the remainder of the examination was excluded from the review to minimize reviewer bias. Each lesion was evaluated for (1) the presence or absence of globular enhancement (defined as enhancing nodules less than 1 cm seen within a lesion), (2) the density of globular enhancement relative to that of the aorta, (3) the degree of border definition (well or poorly marginated), and (4) the presence or absence of a hypodense halo. A diagnostic impression was then recorded for each lesion.. Globular enhancement was 88% sensitive and 84-100% specific for differentiating hepatic hemangiomas from hypervascular metastases (p < .001). A mean of 62% of hemangiomas showed globular enhancement isodense relative to that of the aorta; none of the metastases showed globular, isodense enhancement. The majority of the metastases showed nonglobular enhancement (mean, 92%). The reviewers showed 84% agreement in the identification of (1) globular enhancement in hemangiomas, (2) lack of globular enhancement in metastases, and (3) globular enhancement in the combined set of all lesions. Neither the presence of a hypodense halo nor the degree of border definition was significant in distinguishing between the two groups of lesions. The reviewers showed 96% agreement in the categorization of metastases and 76% agreement in the categorization of hemangiomas. There was 86% agreement in the categorization of all lesions. Overall, reviewers diagnosed a mean of 89% of lesions correctly. A mean of 98% of metastases and a mean of 80% of hemangiomas were diagnosed correctly.. Globular enhancement is highly sensitive (88%) and specific (84-100%) for differentiating hepatic hemangiomas from hypervascular metastases on single-pass, contrast-enhanced CT scans.

Topics: Adult; Aged; Diagnosis, Differential; Female; Hemangioma; Humans; Iopamidol; Iothalamate Meglumine; Liver; Liver Neoplasms; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed

Iopamidol (280 mgI/ml) was compared with Conray 60 (iothalmate meglumine, 282 mgI/ml) during selective and superselective cerebral arteriography. Twelve patients were examined, and a total of 51 selective injections were compared. Iopamidol produced significantly less pain and burning than Conray 60 and caused no patient motion.

Topics: Adult; Aged; Cerebral Angiography; Clinical Trials as Topic; Double-Blind Method; Facial Neoplasms; Female; Hemangioma; Humans; Intracranial Arteriovenous Malformations; Iopamidol; Iothalamate Meglumine; Iothalamic Acid; Male; Meningeal Neoplasms; Meningioma; Middle Aged

To compare the appearance of small hepatic hemangiomas at nonenhanced and contrast material-enhanced helical computed tomography (CT) with that of small (<3-cm) hypervascular malignant liver tumors and to evaluate the accuracy of multiphase helical CT for differentiating small hemangiomas from small hypervascular malignant tumors.. Radiologists reviewed multiphase helical CT liver images in 86 patients with 37 hemangiomas and 49 malignant liver tumors. They evaluated lesion type and degree of enhancement for change from arterial to portal venous phase. They rated their confidence in the discrimination of hemangiomas from malignant tumors.. At arterial phase CT, enhancement similar to aortic enhancement was observed in 19%-32% of hemangiomas and 0%-2% of malignant tumors; globular enhancement, in 62%-68% and 4%-12%, respectively. At portal venous phase CT, enhancement similar to blood pool enhancement was observed in 43%-54% of hemangiomas and 4%-14% of malignant tumors; globular enhancement, in 46%-49% and 0%-2%, respectively. For all readers and all phases of enhancement, the area under the receiver operating characteristic curves was 0.81-0.87, indicating that inherent accuracy of CT is high and that there was no significant difference (P >.28) in overall accuracy. Readers diagnosed hemangiomas with 47%-53% mean sensitivity with all enhancement phases and diagnosed malignant lesions with 95% mean specificity.. Small hemangiomas frequently show atypical appearances at CT. Two-phase helical CT does not improve sensitivity but does improve specificity for differentiating hemangiomas from hypervascular malignant tumors.

Topics: Carcinoma, Hepatocellular; Contrast Media; Diagnosis, Differential; Female; Hemangioma; Humans; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Observer Variation; ROC Curve; Sensitivity and Specificity; Tomography, X-Ray Computed; Triiodobenzoic Acids

Prolonged dynamic CT up to 32 minutes after intravenous bolus injection of 100 ml contrast medium improves the differentiation between benign (hemangiomas) and malignant (metastases) liver lesions. Our study shows that there are three distinct types of hemangiomas and that all three of them behave differently than metastases. Prolonged dynamic improves the problem of differentiation between hemangiomas and metastases but does not solve the problem completely.

Topics: Diagnosis, Differential; Hemangioma; Humans; Iothalamate Meglumine; Liver; Liver Neoplasms; Tomography, X-Ray Computed