Focal hepatic lesion detection: comparison of four fat-suppressed T2-weighted MR imaging pulse sequences

To evaluate fat-suppressed T2-weighted magnetic resonance (MR) imaging with conventional spin-echo (SE), breath-hold fast SE, respiratory-triggered fast SE, and breath-hold multishot SE echo-planar sequences for the detection of focal hepatic lesions.

Fat-suppressed T2-weighted MR images obtained with the four sequences in 55 patients with 81 solid and 129 nonsolid lesions were retrospectively analyzed. Image review was conducted on a segment-by-segment basis; a total of 440 liver segments were reviewed separately for solid and nonsolid lesions by three independent radiologists. Diagnostic accuracy was evaluated with receiver operating characteristic analysis.

The mean lesion-to-liver contrast-to-noise ratio was highest on the multishot SE echo-planar images of both solid and nonsolid lesions. Fat-suppressed respiratory-triggered fast SE images had significantly better (P < .05) or comparative detectability of both solid and nonsolid lesions compared with the other types of images. Image quality was best on the respiratory-triggered fast SE images.

Fat-suppressed respiratory-triggered fast SE imaging should replace fat-suppressed conventional SE imaging as a standard T2-weighted imaging examination in the detection of focal hepatic lesions.