Hepatic tumors: magnetization transfer MR imaging with gadolinium enhancement

Thirty patients with 15 hepatocellular carcinomas, 10 metastases, four hemangiomas, and one cholangiocarcinoma underwent magnetic resonance imaging at 1.5 T with T1-weighted, T2-weighted spin-echo (SE) images, gradient-echo (GRE) magnetization transfer (MT) images, and gadolinium-enhanced T1-weighted SE and MT-GRE images. The MT effect and lesion-liver contrast-to-noise ratio (C/N) were calculated and visual assessment (qualitative analysis) performed for unenhanced and enhanced MT-GRE images and enhanced T1-weighted SE images. The C/N values for hepatic adenocarcinomas (seven metastases and one cholangiocarcinoma) and hemangiomas were larger for enhanced MT-GRE images (adenocarcinoma, 8.4 +/- 2.3 [P < .01]; hemangioma 24 +/- 2.1 [P < .05]) than for enhanced GRE images (5.0 +/- 1.9 and 18 +/- 2.7, respectively). These enhancing tumors had the highest scores in the qualitative analysis. Enhanced MT-GRE images showed no advantage for depiction of hepatocellular carcinomas relative to the other images.