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Liver Lesion Conspicuity: T2-weighted Breath-hold Fast Spin-Echo MR Imaging before and after Gadolinium Enhancement—Initial Experience¹

¹ From the Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, 1096 Main Bldg, Philadelphia, PA 19107. Received May 10, 2000; revision requested June 18; final revision received November 17; accepted December 5. Address correspondence to D.G.M. (e-mail: donald.mitchell@mail.tju.edu).

PURPOSE: To evaluate the effect of a gadolinium chelate on T2-weighted breath-hold fast spin-echo magnetic resonance images of focal hepatic lesions.

MATERIALS AND METHODS: In 21 patients with focal hepatic lesions, identical T2-weighted breath-hold fast spin-echo images were obtained before and after gadolinium enhancement and were compared regarding lesion-to-liver contrast-to-noise ratio, signal-to-noise ratio, lesion conspicuity, and vascular pulsation artifact. Image review was performed independently, in random order, by two experienced radiologists.

RESULTS: For solid lesions, the lesion-to-liver contrast-to-noise ratio on enhanced images was significantly higher (P < .05) than that on nonenhanced images. For nonsolid lesions, however, there was no significant difference (P = .07). For both readers, lesion conspicuity for solid lesions on enhanced images was significantly higher than on nonenhanced images (P < .05). Severity of vascular pulsation artifact was not significantly different.

CONCLUSION: Solid-lesion contrast on T2-weighted breath-hold fast spin-echo images improves after administration of a gadolinium chelate. These images should be obtained after, rather than before, gadolinium enhancement.

Index terms: Gadolinium • Liver, MR, 761.121411, 761.121412, 761.12143 • Liver neoplasms, diagnosis, 761.312, 761.319, 761.323 • Magnetic resonance (MR), contrast enhancement, 761.12143

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