Fat-suppressed T2-weighted MR imaging of hepatocellular carcinoma and metastases: Comparison of conventional spin-echo, fast spin-echo, and echoplanar pulse sequences

The purpose of our study was to compare the diagnostic accuracy of fat-supp ressed T2-weighted magnetic resonance (MR) images obtained with conventiona l spin-echo (SE), respiratory-triggered fast SE, and breath-hold multishot SE echoplanar (EP) sequences for the detection of hepatocellular carcinoma and metastases. Images obtained with the three sequences in 17 patients (15 with cirrhosis) with 31 hepatocellular carcinomas and 14 patients with 45 metastases were retrospectively analyzed, Image review was conducted on a s egment-by-segment basis; in all, 248 liver segments were reviewed separatel y and independently for detection of solid, malignant lesions. Diagnostic a ccuracy was evaluated with receiver-operating-characteristic (ROC) curve an alysis, Diagnostic accuracy for hepatocellular carcinoma as determined by R OC curve analysis was better by a statistically significant amount for conv entional SE (Az = 0.95) images when compared with respiratory-triggered fas t SE (Az = 0.83, P < 0.05) and breath-hold multishot SE EP (Az = 0.80, P < 0.05) images, Conventional SE MR sequences should not be replaced with resp iratory-triggered fast SE or breath-hold multishot SE EP sequences for T2-w eighted MR imaging of patients with hepatocellular carcinoma in cirrhosis, unless sufficient contrast-enhanced dynamic MR imaging Is subsequently perf ormed. J. Magn. Reson. Imaging 1999; 10:25-32, 1999. (C) 1999 Wiley-Liss, I nc.