Focal hepatic lesion detection: Comparison of four fat-suppressed T2-weighted MR imaging pulse sequences

PURPOSE: To evaluate fat-suppressed T2-weighted magnetic resonance (MR) ima ging with conventional spin-echo (SE), breath-hold fast SE, respiratory-tri ggered fast SE, and breath-hold multishot SE echo-planar sequences for the detection of focal hepatic lesions. MATERIALS AND METHODS: Fat-suppressed T2-weighted MR images obtained with t he four sequences in 55 patients with 81 solid and 129 nonsolid lesions wer e retrospectively analyzed. Image review was conducted on a serment-by-segm ent basis; a total of 440 liver segments were reviewed separately for solid and nonsolid lesions by three independent radiologists. Diagnostic accurac y was evaluated with receiver operating characteristic analysis. RESULTS: The mean lesion-to-liver contrast-to-noise ratio was highest on th e multishot SE echo-planar images of both solid and nonsolid lesions. Fat-s uppressed respiratory-triggered fast SE images had significantly better (P < .05) or comparative detectability of both solid and nonsolid lesions comp ared with the other types of images. Image quality was best on the respirat ory-triggered fast SE images. CONCLUSION: Fat-suppressed respiratory-triggered fast SE imaging should rep lace fat-suppressed conventional SE imaging as a standard T2-weighted imagi ng examination in the detection of focal hepatic lesions.