Fast spin echo imaging with suspended respiration: gadolinium enhanced MR imaging of liver tumors

Magnetic resonance (MR) imaging of 43 patients with hepatic tumor was performed during suspended respiration using a fast scan spin echo (SE) technique (SE 200/40) with a single excitation. The resulting images were superior in terms of image quality to conventional ones. Due to the lack of soft tissue contrast, 38 patients received Gd-diethylenetriaminepentaacetic acid (DTPA) at 0.05 mmol/kg and serial scanning (CE-MR) was repeated. Twelve of 14 hepatomas showed isointensity or slightly reduced intensity compared with the liver in unenhanced MR. All metastases (nine patients) showed low signal intensity that was statistically significant (p less than 0.001) in differentiating between hepatomas and metastatic liver tumors. With contrast enhanced MR, both hepatomas and metastases showed changes that cannot be further classified until more cases have been examined. In all 12 cavernous hemangioma cases, Gd-DTPA pooling was observed with extremely high contrast, which was a pathognomonic sign. In fact, four cavernous hemangiomas in two patients with a diameter of 1.0 cm were successfully imaged.