Liver lesion conspicuity: T2-weighted breath-hold fast spin-echo MR imaging before and after gadolinium enhancement-initial experience

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.