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 p atients with 108 focal hepatic masses had, prospectively, MR of the li ver 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 obtain ed with and without fat suppression, T2-weighted BHFSE (2700/105; echo train length = 20; acquisition time = 22 sec), and 3D rapid ORE image s (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 an d after injection of a gadolinium chelate were blindly and independent ly 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-e cho with fat suppression images (76 of 108, sensitivity = 70%), T2-wei ghted fast spin-echo without fat suppression images (76 of 108, sensit ivity = 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-we ighted sequences. CONCLUSION. Gadolinium chelate-enhanced 3D rapid GRE imaging is superior to T2-weighted fast spin-echo images obtained wit h 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.