Breath-hold T2-weighted MRI of hepatic tumors: Value of echo planar imaging with diffusion-sensitizing gradient

Purpose: The purpose of our study was to evaluate the efficacy of echo planar imaging (EPI) as a breath-holding T2-weighted technique for imaging focal hepatic lesions. Method: Forty-eight patients with focal hepatic lesions (9 metastases, 21 hepatocellular carcinomas, 1 cholangiocarcinoma, 16 hemangiomas, and 2 cysts) underwent single shot EPI with and without a small diffusion-sensitizing gradient (DSG) (b values = 55 s/mm(2)) at 1.5 T. Comparison was made with breath-holding T2-weighted fast SE (FSE) sequences. Results: Lesion-to-Liver signal intensity ratio of EPI was significantly better than that of T2-weighted FSE (p < 0.05) in patients with metastasis. Use of DSG suppressed bright signals from vessels or periportal tissue, resulting in better conspicuity of small lesions. EPI with DSG visualized more metastatic deposits than T2-weighted FSE (p < 0.01). Conclusion: EPI with a small DSG is helpful for detection of small hepatic metastases.