MR imaging of focal liver lesions: comparison between turbo spin-echo and conventional spin-echo pulse sequences

The aim of this study was to compare conventional spin-echo (CSE) T2-weighted (T2W) images with turbo spin-echo (TSE) T2W pulse sequences in their ability to detect focal liver lesions. Seventy-eight consecutive patients with focal liver lesions were entered into this study. All patients were imaged using the gradient-echo (GE) sequence with the breath-hold technique for T1-weighted (T1W) images, and CSE and TSE sequences for T2W images. Qualitative evaluation included lesion detection (number of lesions detected) and conspicuity (extent of visualization of lesional borders); quantitative evaluation included the signal-to-noise (S/N) ratio and the contrast-to-noise (C/N) ratio. TSE showed the best performance in terms of lesion detection; however, the difference between TSE and CSE was significant only in the case of benign cysts (p < 0.01). Conspicuity was higher with TSE and CSE, and lower with GE. The S/N and C/N ratios of the two T2W sequences were also comparable, and better than those of GE. However, the combined use of GE and TSE resulted in improved lesion detection. The results show that, because the acquisition time is greatly reduced with TSE sequences, these should be considered as first-line approach to magnetic resonance imaging of the liver for the study of focal lesions.