DIFFERENTIATION BETWEEN HEPATIC CAVERNOUS HEMANGIOMA AND MALIGNANT-TUMOR WITH T2-WEIGHTED MRI - COMPARISON OF FAST SPIN-ECHO AND BREATHHOLDFAST SPIN-ECHO PULSE SEQUENCES

Purpose: The goal of our study was to compare a T2-weighted breathhold fast spin-echo (BHFSE) technique with T2-weighted nonbreathhold fast spin-echo (FSE) technique for characterizing cavernous hemangioma of t he liver and differentiating this entity from malignant tumor. Materia ls and methods: Eighteen patients with cavernous hemangiomas and 18 pa tients with malignant hepatic tumors were studied with T2-weighted MRI with a nonbreathhold FSE technique with and without fat suppression a nd with a BHFSE technique without fat suppression, Hepatic lesions wer e analyzed quantitatively using signal intensity (SI) and contrast-So- noise (C/N) ratio. in addition, images were qualitatively compared for accuracy in characterizing hepatic lesion, Results: Quantitatively, h emangioma had significantly higher SI and C/N ratios than did the mali gnant tumor on every pulse sequence (P < 0.01). Qualitatively, all mal ignant tumors were correctly categorized; differentiation between cave rnous hemangioma and malignant tumor was impossible in three cases of cavernous hemangioma with the three pulse sequences (92% accuracy, 100 % sensitivity, and 83% specificity). Conclusion: T2-weighted FSE and B HFSE MRI shorts comparable levels of accuracy for differentiating betw een hepatic cavernous hemangioma and malignant tumor. Because overlap may exist using quantitative measurement, morphologic patterns must be carefully analyzed, supporting that quantitative analysis and morphol ogic evaluation are complementary. (C) Elsevier Science Inc., 1998.