Detection of focal hepatic lesions with MR imaging: prospective comparison of T2-weighted fast spin-echo with and without fat suppression, T2-weighted breath-hold fast spin-echo, and gadolinium chelate-enhanced 3D gradient-recalled imaging.

OBJECTIVE The purpose of this study was to compare breath-hold three-dimensional (3D) rapid gradient-echo (GRE) MR imaging obtained before and after gadolinium chelate injection with T2-weighted fast spin-echo and T2-weighted breath-hold fast spin-echo (BHFSE) MR imaging in the detection of focal hepatic masses. SUBJECTS AND METHODS Fifty-three patients with 108 focal hepatic masses had, prospectively, MR of the liver at 1.5 T. T2-weighted fast spin-echo (6000/117 [TR/effective TE]; echo train length=16; acquisition time = 3 min 12 sec) images obtained with and without fat suppression, T2-weighted BHFSE (2700/105; echo train length = 20; acquisition time = 22 sec), and 3D rapid GRE images (10.1/1.9/30 degrees [TR/TE/alpha]) obtained during one breath-hold (12 scan locations in 21 sec or 20 scan locations in 32 sec) before and after injection of gadolinium chelate were blindly and independently analyzed in consensus by three readers. RESULTS Gadolinium chelate-enhanced 3D rapid GRE images allowed depiction of more focal hepatic masses (90 of 108, sensitivity = 83%) than did T2-weighted fast spin-echo with fat suppression images (76 of 108, sensitivity = 70%), T2-weighted fast spin-echo without fat suppression images (74 of 108, sensitivity = 69%), T2-weighted BHFSE images (73 of 108, sensitivity = 68%), and unenhanced 3D rapid GRE images (54 of 108, sensitivity = 50%) (p < .01). No difference in sensitivity was found between the three T2-weighted sequences. CONCLUSION Gadolinium chelate-enhanced 3D rapid GRE imaging is superior to T2-weighted fast spin-echo images obtained with or without fat suppression for the detection of focal hepatic masses. T2-weighted BHFSE is similar to T2-weighted fast spin-echo images in detecting focal hepatic lesions.