Hepatic Malignant Tumour Versus Cavernous Haemangioma: Differentiation on Multiple Breath-hold Turbo Spin-echo MRI Sequences with Different T2-weighting and T2-relaxation Time Measurements on a Single Slice Multi-echo Sequence

Abstract

AIM: We evaluated the signal intensity change on breath-hold turbo spin-echo (TSE) T2-weighted sequences using different echo times (TE) and T2-relaxation time measurements on a single slice eight-echo sequence in the differentiation of hepatic malignancy from cavernous haemangioma. MATERIALS AND METHODS: Breath-hold TSE T2-weighted axial images of the liver were performed at TEs of 80, 120 and 160ms in 34 patients with focal liver lesions (13 with cavernous haemangiomas, 14 with hepatocellular carcinomas and seven with metastases). The lesion percentage signal intensity change on the lower TE image to the higher TE image was calculated. T2-relaxation time was measured on a single slice eight-echo sequence. RESULTS: The TE pair 80/160ms on breath-hold TSE T2-weighted sequences gave a performance (100% sensitivity, 92% specificity, 95% positive predictive value and 100% negative predictive value) better than other TE pairs in differentiating haemangioma from malignancy. Addition of fat-suppression compromised the diagnostic performance for all TE-pairs. The use of T2 relaxation time threshold of <112ms as indicative of malignant lesion achieved a 100% sensitivity, 77% specificity, 88% positive predictive value and 100% negative predictive value. CONCLUSION: Percentage signal intensity change on breath-hold TSE T2-weighted sequences at TE 80/160ms appears to be a quick and potentially useful means of differentiating hepatic malignancy from haemangioma. Chan, Y. L.et al. (2002). Clinical Radiology57, 250–257.