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Gastrointestinal Imaging |
1 From the Departments of Clinical Radiology (J.W., J.A.G., P.J.R.), Medical Physics (D.W.), Hepatobiliary Surgery (J.P.A.L.), and Pathology (J.I.W.), St James's University Hospital, Beckett St, Leeds LS9 7TF, United Kingdom; and the Department of Radiology, Nanjing Railway Medical College Hospital, People's Republic of China (F.C.). Received December 2, 1998; revision requested December 30; revision received May 5, 1999; accepted July 30. Address reprint requests to J.W. (e-mail: 113566.2505@compuserve.com).
PURPOSE: To compare the accuracy of five T2-weighted sequences in the detection of liver lesions at magnetic resonance (MR) imaging after superparamagnetic iron oxide (SPIO) enhancement.
MATERIALS AND METHODS: Forty-nine candidates for hepatic resection with known colorectal metastases were examined. Before SPIO enhancement, fast spin-echo (SE) images were obtained. After enhancement, the same fast SE sequence and long TR/short TE, short TE, long TR/TE, and T2-weighted fast low-angle shot (FLASH) sequences were used. All images were viewed independently by four observers who were blinded to the results of the other imaging sequences, the results of the other observers, and the findings at surgery and histopathologic examination. Four weeks after the initial reading, the combined long TR/short TE and long TR/TE dual-echo images were also viewed as an additional set. The alternative free response receiver operating characteristic (ROC) method was used to analyze the results, which were correlated with findings at surgery, intraoperative ultrasonography, and histopathologic examination.
RESULTS: Irrespective of lesion size, the accuracy of all sequences after enhancement was significantly greater than that of the nonenhanced fast SE sequence (P < .01). Dual-echo and FLASH sequences were significantly more accurate than the enhanced fast SE sequence (P < .03 or P < .02, respectively). For all lesions, lesions smaller than 1 cm, and lesions 1 cm or larger, mean accuracies were as follows: dual-echo, 0.75, 0.54, and 0.93; FLASH, 0.75, 0.54, and 0.95; and enhanced fast SE, 0.72, 0.49, and 0.92.
CONCLUSION: At 1.0 T, dual-echo and FLASH sequences are the most accurate pulse sequences after SPIO enhancement.
Index terms: Iron, 761.12143 • Liver neoplasms, metastases, 761.3327 • Liver neoplasms, MR, 761.121411, 761.121412, 761.12143, 761.3327 • Magnetic resonance (MR), comparative studies, 761.121411, 761.121412, 761.12143 • Magnetic resonance (MR), contrast enhancement, 761.121411, 761.121412, 761.12143 • Receiver operating characteristic (ROC) curve
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