Surgery has become an effective method for treating liver tumours. It would not have been possible were it not for modern imagine techniques using hepatotropic contrasts. However, their use is also done together with serious costs, and this ensures that you pay attention to the choice of optimal remedy used for contrasting organs and pathological formations.
Innovative contrasting drug Primovist (gadoxeic acid), unlike its predecessors, has a path to liver cells. After intravenous introduction, primrovist is quickly distributed in the bloodstream and extracellular space, and then with the help of special “carriers” is dragged inside the cell. No contrasting drug, except hepatotropic, can penetrate the cell (tissue), and this is its uniqueness. The main advantage of MR-cholangigorafia of the liver and the biliary tract with the use of Primovist is the possibility of differential diagnosis of focal liver pathology and diagnosis of the pathology of the bile ducts.
Considering the long time of contrast, Primovist’s entry into the gallbladder and discharge in the lumen of the duodenum, it makes it possible to asses the functional state of the biliary tract.
Features of the metabolism of the drug allow to differentiate benign tumors from malignancies, to identify additional metastases and to differentiate primary liver tumours from metastases. The use of Primovist allows to solve several problems of diagnosing tumours and non-tumour diseases of the liver and bile tract within the framework of only one MRI study. The primacy combines the ability to selectively visualize the liver and excellent tolerance after intravenous pain administration.
Possibilities:
Intracellular (hepatospecific) MR-contrasting means accumulation in liver cells (in the late hepatospecific phase)
- the possibility of differential diagnosis
of pathological hearths due to the specifics of the accumulation of contrasting means. - Detection of small pathological formations less
than 1 cm in diameter due to contrast of liver parenchyma and high contrast of the image. - The possibility of detecting
the pathology of the bile tract by allocating a contrast remedy with bile - The effect of increasing contrast is due to a stable complex of gadolinium – Gd-EOB-DTPA and to a small extent depends on the tension of the magnetic field.
The benefits of MRI research with the drug Primovist compared to other (extracellular) contrast drugs are:
- It can be used in patients with renal or liver failure – complete removal from the body within 24 hours.
- If one selection path is blocked, the Primovist is naturally singled out in an unmodified form for 72 hours in the other way.
- It allows for specific diagnosis of focal and diffuse diseases of the liver, gallbladder and bile ducts:
- differential diagnosis of liver cancer (exclusion of benign formations)
- Significantly increases the level of confidence in the detection of tumours and liver metastases compared to standard (extracellular) contrast substances.
- Allows to assess the blood supply of the identified formation (in the dynamic phases of the study) and the degree of germination of it into the wall of the vessel. This is critical in choosing the tactics of further surgical treatment, or the refusal of surgery.
- Assessment of the excretion and cumulative function of the gallbladder and bile ducts. This is the only non-ionizing (non-radiation-in using patient) technique that allows for functional diagnosis of these organs.
- Contrast of bile ducts allows to reliably study the individual architecture of the bile tree, especially it is valuable before laparoscopic cholecystectomy.
In some diagnostic centres, the methods and protocols of conducting research with the drug Primovist on the whole spectrum of diseases have been worked out.
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