Improved focal liver lesion detection: comparison of single-shot diffusion-weighted echoplanar and single-shot T2 weighted turbo spin echo techniques

Br J Radiol. 2007 Jul;80(955):524-31. doi: 10.1259/bjr/33156643. Epub 2007 May 17.

Abstract

The purpose of this study was to compare diffusion-weighted respiratory-triggered single-shot spin echo echoplanar imaging (SS SE-EPI) sequence using four b-values (b = 0, b = 20, b = 300, b = 800 s mm(-2)) and single-shot T2 weighted turbo spin echo (T2W SS TSE) in patients with focal liver lesions, with special interest in small (<10 mm) lesions. Twenty-four patients underwent routine MRI. The five sequences were compared qualitatively for image quality, lesion conspicuity and artefacts. Quantitative analysis was performed for lesion identification and lesion-to-liver contrast-to-noise ratio (CNR). Subgroup analyses were performed for different types of lesions with different sizes. Sequences were compared by rank order statistic (RIDIT) and Kruskal-Wallis test. The best image quality (p<0.05) was achieved with T2W TSE and the best lesion conspicuity (p<0.05) with T2W TSE for biliary cysts and SE-EPI diffusion-weighted imaging (DWI) (b = 20 s mm(-2)) for haemangiomas and metastases. Image artefacts were lowest (p<0.05) with T2W TSE. T2W TSE was found to be the best protocol (p<0.05) for the identification of biliary cysts and SE-EPI DWI (b = 20 s mm(-2)) for haemangiomas and metastases. The lesion-to-liver CNRs were highest on T2W TSE for biliary cysts and on SE-EPI diffusion-weighted imaging (DWI) for haemangiomas and metastases (p<0.05). This study shows the potential of SS SE-EPI DWI (especially with a b-value of 20 s mm(-2)) as a promising technique for detecting small (<10 mm) focal liver lesions.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Artifacts
  • Bile Duct Diseases / diagnosis
  • Cysts / diagnosis
  • Diffusion Magnetic Resonance Imaging / methods
  • Echo-Planar Imaging / methods*
  • Female
  • Hemangioma / diagnosis
  • Humans
  • Image Interpretation, Computer-Assisted
  • Liver / pathology*
  • Liver Diseases / diagnosis*
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Probability
  • Statistics as Topic