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    Magnetic resonance imaging with Gadolinium-DTPA for assessment of bladder carcinoma and its response to treatment.

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    Authors
    Hawnaur, J M
    Johnson, Richard J
    Read, G
    Isherwood, I
    Affiliation
    Department of Diagnostic Radiology, University of Manchester.
    Issue Date
    1993-05
    
    Metadata
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    Abstract
    Magnetic Resonance Imaging (MRI) with intravenous Gadolinium-DTPA (Gd-DTPA, Magnevist, Schering-AG) was performed in 44 patients, 32 with primary bladder carcinoma and 12 with suspected recurrence after treatment. Gd-DTPA often increased diagnostic confidence in the identification and staging of tumours confined to the bladder wall and was necessary to assess depth of bladder wall invasion when T2-weighted images were suboptimal. Enhancement after Gd-DTPA enabled distinction between necrotic and viable tumour and blood clot. There was little advantage in its use for tumours infiltrating perivesical fat or with metastases to lymph nodes or bone, in the absence of a fat suppression sequence. Gd-DTPA may therefore be useful in selected patients with tumours of Stage T3a or less in whom information about depth of bladder wall invasion is inadequately shown on pre-contrast sequences. Artefacts due to variable and inhomogeneous urine signal intensity, however, often degraded post-Gd-DTPA images of the bladder. Changes in the bladder due to radiotherapy were observed on MRI 3-4 months after treatment in patients referred for routine follow-up and in some patients with suspected recurrence. Mucosal hyperintensity, thickening and abnormal signal intensity of the muscular layers of the bladder wall, with enhancement after Gd-DTPA were demonstrated. Such changes obscured small volume or superficial recurrence of tumour after radiotherapy. Abnormal enhancement was also observed in pelvic organs and soft tissues irradiated several years earlier. Enhancement after Gd-DTPA does not therefore reliably distinguish between recurrent tumour and radiotherapy change.
    Citation
    Magnetic resonance imaging with Gadolinium-DTPA for assessment of bladder carcinoma and its response to treatment. 1993, 47 (5):302-10 Clin Radiol
    Journal
    Clinical Radiology
    URI
    http://hdl.handle.net/10541/99596
    DOI
    10.1016/S0009-9260(05)81444-8
    PubMed ID
    8508591
    Type
    Article
    Language
    en
    ISSN
    0009-9260
    ae974a485f413a2113503eed53cd6c53
    10.1016/S0009-9260(05)81444-8
    Scopus Count
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