Hepatic lesions: Discrimination of nonsolid, benign lesions from solid, malignant lesions with heavily T2-weighted fast spin-echo MR imaging

被引:79
作者
Ito, K [1 ]
Mitchell, DG [1 ]
Outwater, EK [1 ]
Szklaruk, J [1 ]
Sadek, AG [1 ]
机构
[1] THOMAS JEFFERSON UNIV HOSP,DEPT RADIOL,PHILADELPHIA,PA 19107
关键词
liver; MR; liver neoplasms; diagnosis; magnetic resonance (MR); pulse sequences;
D O I
10.1148/radiology.204.3.9280251
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To determine whether the combined use of heavily and moderately T2-weighted fast spin-echo magnetic resonance (MR) images improves differentiation of nonsolid, benign hepatic lesions from solid malignancies. MATERIALS AND METHODS: Three radiologists reviewed moderately (n = 133) and heavily (n = 133) T2-weighted and multiphasic dynamic contrast material-enhanced (n = 93) MR images in 133 patients with proved focal hepatic lesions (95 benign, 38 malignant). The radiologists used a five-point scale to rate their confidence in determination of malignancy. RESULTS: All three reviewers were statistically significantly better able to differentiate small (diameter less than 3 cm; n = 84) benignancies from small malignancies with the combination of moderately and heavily T2-weighted images (area under the receiver operating characteristic curve, 0.99 for each reader) than with moderately T2-weighted images alone (area, 0.88-0.90; P < .05). Confident diagnoses were rendered in 69 (82%) patients, with 100% accuracy for the combined use of moderately and heavily T2-weighted images. For larger lesions (diameter 3 cm or larger; n = 49), accurate differentiation was possible with moderately T2-weighted images alone. Additional use of multiphasic images did not improve the sensitivity, specificity, or accuracy of image interpretation. CONCLUSION: The combined use of moderately and heavily T2-weighted fast spin-echo MR images improves differentiation of small benign hepatic lesions from small malignant lesions.
引用
收藏
页码:729 / 737
页数:9
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