Diffusion-weighted MR imaging with a single-shot echoplanar sequence: detection and characterization of focal hepatic...

The purpose of this study was to determine the usefulness of diffusion-weighted MR imaging with single-shot echoplanar imaging in characterizing focal hepatic lesions by apparent diffusion coefficient (ADC) and contrast-to-noise ratio (CNR) measurements.

Diffusion-weighted imaging on a 1.5-T MR unit was performed in 46 patients with 74 known focal hepatic lesions (11 hemangiomas, 15 metastases, and 48 hepatocellular carcinomas [HCCs]). Mean values for ADCs and CNRs of all lesions were calculated. Mean values for CNRs with diffusion-weighted imaging were also compared with those for breath-hold T2-weighted fast spin-echo images.

The mean values for ADCs were different for each type of tumor (5.39 x 10(-3) mm2/sec +/- 1.23 in hemangiomas, 2.85 x 10(-3) mm2/sec +/- 0.59 in metastases, and 3.84 x 10(-3) mm2/sec +/- 0.92 in HCCs), and each of them was significantly greater than the mean values for ADCs of the normal liver (2.28 x 10(-3) mm2/sec +/- 1.23 in normal liver [p < .05] except metastasis versus normal liver [p < .1]). Also, the mean values for ADCs were based on differences of ADC values. Only four (6%) of 63 malignant tumors (three HCCs and one metastasis) could not be differentiated from hemangiomas. The mean value for CNRs with diffusion-weighted images (14.4 +/- 8.54 in HCC and 29.0 +/- 6.79 in metastasis) was significantly higher than the mean values for CNRs obtained with T2-weighted fast spin-echo images in both metastases and HCCs (p < .05), whereas no significant difference was seen for hemangiomas.

Mean values for ADCs differed for the three types of the hepatic lesions and were higher than ADCs of the normal liver. We suggest that diffusion-weighted imaging may be useful for increased detection of HCCs and metastases and in distinguishing these entities from hemangiomas.