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Liver: T2-weighted MR Imaging with Breath-hold Fast-Recovery Optimized Fast Spin-Echo Compared with Breath-hold Half-Fourier and Non–Breath-hold Respiratory-triggered Fast Spin-Echo Pulse Sequences¹

¹ From the Departments of Radiology (J.A., O.V., P.L., H.G.) and Biostatistics (J.C.), Université René Descartes, Hôpital Cochin, 27 rue du Fg Saint Jacques, 75679 Paris Cedex 14, France; and GE Medical Systems, Buc, France (C.A.). Received June 7, 2001; revision requested July 3; revision received October 18; accepted December 10. Address correspondence to O.V. (e-mail: olivier.vignaux@cch.ap-hop-paris.fr).

View larger version (31K): [in a new window]   Figure 1. Pulse sequence timing diagram illustrates the fast-recovery modification. Once the final echo in the fast SE (FSE) echo train has been acquired, an additional 180° (180 deg) pulse refocuses the residual magnetization in the transverse plane, and then a -90° (-90 deg) pulse flips it back to the longitudinal axis instead of allowing it to recover with T1 processes. RF = radio frequency.

View larger version (159K): [in a new window]   Figure 2a. (a) Respiratory-triggered (3,600/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a patient with a small peripheral liver hemangioma (arrow). Depiction and sharpness of the lesion are best in b. In c, the lesion is partially located in an intersection gap, which results in a partial volume effect and thus a loss of signal intensity and lesion contours. A blurring effect may also account for this aspect. Both reviewers mistook the lesion in c for an intrahepatic anatomic structure.

View larger version (152K): [in a new window]   Figure 2b. (a) Respiratory-triggered (3,600/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a patient with a small peripheral liver hemangioma (arrow). Depiction and sharpness of the lesion are best in b. In c, the lesion is partially located in an intersection gap, which results in a partial volume effect and thus a loss of signal intensity and lesion contours. A blurring effect may also account for this aspect. Both reviewers mistook the lesion in c for an intrahepatic anatomic structure.

View larger version (161K): [in a new window]   Figure 2c. (a) Respiratory-triggered (3,600/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a patient with a small peripheral liver hemangioma (arrow). Depiction and sharpness of the lesion are best in b. In c, the lesion is partially located in an intersection gap, which results in a partial volume effect and thus a loss of signal intensity and lesion contours. A blurring effect may also account for this aspect. Both reviewers mistook the lesion in c for an intrahepatic anatomic structure.

View larger version (144K): [in a new window]   Figure 3a. (a) Respiratory-triggered (3,800/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a 54-year-old man with hepatocellular carcinoma. The main lesion (arrowheads) is clearly visible in a-c, but a small lesion in the left lobe (arrow) is less apparent in a than in b. In c, the small lesion is partially obscured by the hepatic vasculature and is depicted with poor lesion sharpness owing to an image blurring effect.

View larger version (159K): [in a new window]   Figure 3b. (a) Respiratory-triggered (3,800/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a 54-year-old man with hepatocellular carcinoma. The main lesion (arrowheads) is clearly visible in a-c, but a small lesion in the left lobe (arrow) is less apparent in a than in b. In c, the small lesion is partially obscured by the hepatic vasculature and is depicted with poor lesion sharpness owing to an image blurring effect.

View larger version (161K): [in a new window]   Figure 3c. (a) Respiratory-triggered (3,800/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a 54-year-old man with hepatocellular carcinoma. The main lesion (arrowheads) is clearly visible in a-c, but a small lesion in the left lobe (arrow) is less apparent in a than in b. In c, the small lesion is partially obscured by the hepatic vasculature and is depicted with poor lesion sharpness owing to an image blurring effect.

View larger version (150K): [in a new window]   Figure 4a. (a) Respiratory-triggered (3,800/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a 28-year-old woman with focal nodular hyperplasia. The lesion is isointense to the liver parenchyma. Diagnosis was made possible by the high signal intensity of the central scar (arrow). The scar is clearly depicted in b but is less conspicuous in c owing to a slight blurring effect. In a, ghosting artifacts obscure the scar.

View larger version (145K): [in a new window]   Figure 4b. (a) Respiratory-triggered (3,800/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a 28-year-old woman with focal nodular hyperplasia. The lesion is isointense to the liver parenchyma. Diagnosis was made possible by the high signal intensity of the central scar (arrow). The scar is clearly depicted in b but is less conspicuous in c owing to a slight blurring effect. In a, ghosting artifacts obscure the scar.

View larger version (147K): [in a new window]   Figure 4c. (a) Respiratory-triggered (3,800/90), (b) breath-hold fast-recovery (3,000/90), and (c) half-Fourier single-shot (/90) transverse fast SE T2-weighted MR images in a 28-year-old woman with focal nodular hyperplasia. The lesion is isointense to the liver parenchyma. Diagnosis was made possible by the high signal intensity of the central scar (arrow). The scar is clearly depicted in b but is less conspicuous in c owing to a slight blurring effect. In a, ghosting artifacts obscure the scar.