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20 May 2010

Comparison of efficacy of MR sequences used for detection of focal liver lesions

Andrzej Cieszanowski, Agnieszka Grodzicka, Edyta Maj, Barbara Gornicka, Kaczynski Bartosz, Mariusz Grodzicki, Marek Krawczyk, Olgierd Rowinski

Med Sci Monit 2010; 16(1): 66-74 :: ID: 880586

Abstract

Background: The purpose of this study was to compare the sensitivities of different MR sequences (T2 TSE, DW EPI, T1 SGE) in detection of focal hepatic lesions.
Material/Methods: Evaluation included the MR studies (1.5T Unit: Magnetom Avanto) of 81 patients. Pathologic verification was obtained in 29 patients, whereas in remaining 52 patients, final diagnosis was based on other imaging studies, follow-up, and clinical data. In 56 patients, 171 liver lesions were confirmed: 84 malignant (52 metastases, 20 HCCs, 9 hemangioendotheliomas, 2 CCAs, 1 cystadenocarcinoma), and 87 benign (35 cysts, 31 hemangiomas, 13 abscesses, 7 FNHs, 1 cystadenoma). In 25 patients, liver lesions were excluded. Two radiologists identified the number of lesions on images obtained with the use of following sequences: T2WTSE, T2W fat-sat TSE, DW EPI (b=50,400,800 s/mm2), chemical shift T1 SGE (In-Out SGE), 3D T1 spoiled gradient-echo 3DT1SGE, dynamic 3DT1SGE post-Gd-BOPTA injection (with arterial, portal venous, parenchymal, 5 min-delayed phases) and 3DT1SGE 60-90 min post-Gd-BOPTA.
Results: Applied MR techniques yielded following sensitivities for detection of focal hepatic lesions: T2TSE 78.9%, T2 fat-sat 89.5%, DW EPI 95.9%, chemical shift T1SGE 80.7%, 3DT1SGE 81.9%, 3DT1SGE in arterial phase 93.0%, in portal venous phase 92.4%, in parenchymal phase 87.7%, in delayed phase 87.1%, and in hepatobiliary phase (60–90 min post-Gd-BOPTA) 84.8%.
Conclusions: The highest number of focal hepatic lesions was visualized on DW EPI sequence (n=164, sensitivity – 95.9%), followed by 3DT1SGE in arterial phase (n=159, sensitivity – 93.0%), 3DT1SGE in portal venous phase (n=158, sensitivity – 92.4%), and T2TSE fat-sat sequence (n=153, sensitivity – 89.5%).

Keywords: Magnetic Resonance Imaging, Liver Neoplasms, Contrast Media, Gadobenate dimeglumine

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750