Abstract
Objective: To evaluate the usefulness of sequential T2-weighted spin-echo type multishot echo-planar (T2-EP) imaging with gadopentetate dimeglumine for the detection of hypovascular metastatic liver tumors.
Material and Methods: Fifteen consecutive patients with 56 proven hypovascular metastatic liver tumors were included in the study. Three observers blindly and independently read the whole-liver images obtained with T2-weighted spin-echo, T2-weighted single-shot fast spin-echo, T1-weighted fast multiplanar spoiled GRASS and T2-EP images obtained before and 25, 60, 90 and 120 s after injection of 0.2 mmol/kg b.w. of gadopentetate dimeglumine. The diagnostic accuracy was estimated by calculating the area under the observer-specific binomial receiver operating characteristics curves (Az).
Results: T2-EP images obtained 60 s after contrast injection showed significantly higher contrast-to-noise (C/N) ratios than the other imaging techniques. A combination of all phases of the T2-EP images produced the highest sensitivity and specificity. In terms of the Az value, the diagnostic accuracy for tumor detection achieved with a combination of all phases of the T2-EP images was significantly higher than that with T1-SPGR and T2-SSFSE images (p < 0.01). The Az values of the T2-EP images (Az = 0.975) were higher than those of T2-CSE images (Az = 0.948), but the difference was not significant.
Conclusion: Our preliminary study revealed that sequential imaging with enhanced T2-EP images was useful for the detection of hypovascular metastatic liver tumors because of its superior C/N ratio and sensitivity.
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