• K Ito, D G Mitchell, E K Outwater, J Szklaruk, and A G Sadek.
• Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
• Radiology. 1997 Sep 1; 204 (3): 729-37.

PurposeTo determine whether the combined use of heavily and moderately T2-weighted fast spin-echo magnetic resonance (MR) images improves differentiation of non-solid, benign hepatic lesions from solid malignancies.Materials And MethodsThree 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.ResultsAll 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.ConclusionThe combined use of moderately and heavily T2-weighted fast spin-echo MR images improves differentiation of small benign hepatic lesions from small malignant lesions.

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