Liver Lesion Conspicuity: T2-weighted Breath-hold Fast Spin-Echo MR Imaging before and after Gadolinium Enhancement—Initial Experience

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Abstract
To evaluate the effect of a gadolinium chelate on T2-weighted breath-hold fast spin-echo magnetic resonance images of focal hepatic lesions. 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. 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. 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.

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