The assessment of skin tumors with magnetic resonance with high resolution and a paramagnetic contrast medium

INTRODUCTION: The technologic improvement of surface coils in MRI has allowed better visualization of the skin and thus permitted the clinical use of this technique in dermatology. MRI allows to assess the depth and extent of skin tumors and to detect any malignant transformation. The MR differentiation between benign and malignant skin lesions relies on morphological criteria which however do not have an absolute diagnostic value. We investigated the role of paramagnetic contrast agents in the differentiation between benign and malignant skin lesions. MATERIAL AND METHODS: Forty-one patients, 33 with benign and 8 with malignant skin tumors, were submitted to MRI. All the examinations were performed with a 1.5 T superconductive unit, with a 2.5 cm surface coil. Axial T1- and T2-weighted SE images were acquired with 2 mm slice thickness. Paramagnetic contrast material was administered to all patients. The signal intensity of the skin lesions was calculated before and after paramagnetic contrast agent administration positioning a region of interest. A percentage ratio of contrast enhancement was calculated to quantify contrast agent uptake and the relative values were compared between benign and malignant lesions. A qualitative analysis was also performed rating the contrast enhancement of each lesion as high, intermediate, or absent. RESULTS: The quantitative analysis showed a statistically significant difference (p < .5) between the contrast enhancement values of benign and malignant lesions. In particular, malignancies had values ranging 117.3 (+/- 28.7) to 125 (+/- 32.4), while benign lesions had -20.6 to 99.8 (+/- 21.1). Conversely, no difference in contrast enhancement was found at qualitative analysis. CONCLUSIONS: MRI is a promising tool for characterizing skin tumors. Our preliminary results should be confirmed on larger series of patients with the use of high temporal resolution imaging sequences.