Liver masses: replacement of conventional T2-weighted spin-echo MR imaging with breath-hold MR imaging

To evaluate breath-hold magnetic resonance (MR) imaging with single-shot and multishot T2-weighted fast spin-echo (SE) and inversion-recovery (IR) SE echo-planar (EP) SE (IR-SE-EP) sequences compared with conventional T2-weighted SE imaging for detection of liver masses.

Imaging with all sequences was performed in 32 patients on a 1.5-T whole-body system. Images were compared on the basis of lesion-to-liver contrast-to-noise ratio (C/N), lesion conspicuity, and image quality. Image analysis was performed by two experienced radiologists in consensus.

Lesion-to-liver C/Ns were highest on fat-suppressed-half-Fourier-single-shot-fast-SE images. For solid lesions, the lesion-to-liver C/Ns were highest with IR-fast-SE, which was significantly better (P < .05) than IR-SE-EP and conventional SE techniques and also produced the best image quality. Sensitivity with IR-fast-SE was 96%; with fat-suppressed-half-Fourier-single-shot-fast-SE, 92%; with fat-suppressed-fast-SE, 89%; with IR-SE-EP, 83%; and with conventional SE, 78%.

T2-weighted breath-hold imaging, particularly IR-fast-SE imaging, was more sensitive for hepatic masses than conventional SE imaging, with a substantial reduction in acquisition time. Half-Fourier-single-shot-fast-SE imaging was especially useful in patients who were unable to hold their breath.