HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2303020921v1 230/3/637    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hussain, H. K. Articles by Francis, I. R. Search for Related Content PubMed PubMed Citation Articles by Hussain, H. K. Articles by Francis, I. R.

T2-weighted MR Imaging in the Assessment of Cirrhotic Liver¹

¹ From the Departments of Radiology (H.K.H., I.S., H.V.N., R.C.C., W.J.W., I.R.F.) and Biostatistics (T.D.J.), University of Michigan Hospitals, 1500 E Medical Center Dr, MRI B2B311, Ann Arbor, MI 48109-0030. From the 2001 RSNA scientific assembly. Received July 26, 2002; revision requested September 10; final revision received July 3, 2003; accepted July 31. Address correspondence to H.K.H. (e-mail: hhussain@umich.edu).

PURPOSE: To assess if T2-weighted magnetic resonance (MR) imaging provides added diagnostic value in combination with dynamic gadolinium-enhanced MR imaging in the detection and characterization of nodular lesions in cirrhotic liver.

MATERIALS AND METHODS: Two readers retrospectively and independently analyzed 54 MR imaging studies in 52 patients with cirrhosis. In session 1, readers reviewed T1-weighted and dynamic gadolinium-enhanced images. In session 2, readers reviewed T1-weighted, dynamic gadolinium-enhanced, and respiratory-triggered T2-weighted fast spin-echo images. Readers identified and characterized all focal lesions by using a scale of 1–4 (1, definitely benign; 4, definitely malignant). Multireader correlated receiver operating characteristic (ROC) analysis was employed to assess radiologist performance in session 2 compared with session 1. The difference in the areas under the ROC curves for the two sessions was tested. In a third session, readers assessed conspicuity of biopsy-proved lesions on T2-weighted MR images by using a scale of 1–3 (1, not seen; 3, well seen) and identified causes of reduced conspicuity.

RESULTS: Two additional benign lesions were detected by each reader in session 2. Fifty-five lesions had pathologic verification, including 32 malignant, three high-grade dysplastic, and 20 benign nodules. There was no significant difference in the area under the ROC curves between the two sessions (P = .48). Thirty-two lesions were inconspicuous on T2-weighted MR images because of parenchymal heterogeneity, breathing artifacts (particularly in patients with ascites), and lesion isointensity with liver parenchyma. T2-weighted MR imaging was useful in the evaluation of cysts and lymph nodes.

CONCLUSION: T2-weighted MR imaging does not provide added diagnostic value in the detection and characterization of focal lesions in cirrhotic liver.

© RSNA, 2004

Index terms: Liver, cirrhosis, 761.288 • Liver neoplasms, 761.31, 761.323, 761.33 • Liver neoplasms, MR, 761.121411, 761.121412, 761.121413, 761.121415, 761.12143

This article has been cited by other articles:

				J. M. Willatt, H. K. Hussain, S. Adusumilli, and J. A. Marrero MR Imaging of Hepatocellular Carcinoma in the Cirrhotic Liver: Challenges and Controversies Radiology, May 1, 2008; 247(2): 311 - 330. [Abstract] [Full Text] [PDF]

				T. Parikh, S. J. Drew, V. S. Lee, S. Wong, E. M. Hecht, J. S. Babb, and B. Taouli Focal Liver Lesion Detection and Characterization with Diffusion-weighted MR Imaging: Comparison with Standard Breath-hold T2-weighted Imaging Radiology, March 1, 2008; 246(3): 812 - 822. [Abstract] [Full Text] [PDF]

				K Coenegrachts, J Delanote, L Ter Beek, M Haspeslagh, S Bipat, J Stoker, F Van Kerkhove, L Steyaert, H Rigauts, and J W Casselman Improved focal liver lesion detection: comparison of single-shot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques Br. J. Radiol., July 1, 2007; 80(955): 524 - 531. [Abstract] [Full Text] [PDF]

				D. A. Aguirre, C. A. Behling, E. Alpert, T. I. Hassanein, and C. B. Sirlin Liver Fibrosis: Noninvasive Diagnosis with Double Contrast Material-enhanced MR Imaging. Radiology, May 1, 2006; 239(2): 425 - 437. [Abstract] [Full Text] [PDF]

				E. M. Hecht, A. E. Holland, G. M. Israel, W. Y. Hahn, D. C. Kim, A. B. West, J. S. Babb, B. Taouli, V. S. Lee, and G. A. Krinsky Hepatocellular Carcinoma in the Cirrhotic Liver: Gadolinium-enhanced 3D T1-weighted MR Imaging as a Stand-alone Sequence for Diagnosis. Radiology, May 1, 2006; 239(2): 438 - 447. [Abstract] [Full Text] [PDF]

				A. E. Holland, E. M. Hecht, W. Y. Hahn, D. C. Kim, J. S. Babb, V. S. Lee, A. B. West, and G. A. Krinsky Importance of Small (<=20-mm) Enhancing Lesions Seen Only during the Hepatic Arterial Phase at MR Imaging of the Cirrhotic Liver: Evaluation and Comparison with Whole Explanted Liver Radiology, December 1, 2005; 237(3): 938 - 944. [Abstract] [Full Text] [PDF]

				M. Kanematsu, S. Goshima, H. K. Hussain, T. D. Johnson, H. V. Nghiem, and I. R. Francis Does T2-weighted MR Imaging Really Add No Value in Detection and Characterization of Focal Lesions in Cirrhotic Liver? * Dr Hussain and colleagues respond: Radiology, February 1, 2005; 234(2): 638 - 640. [Full Text]