Can a Multiphasic Contrast-Enhanced Three-Dimensional Fast Spoiled Gradient-Recalled Echo Sequence Be Sufficient for Liver MR Imaging?

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Abstract
OBJECTIVE. The purpose of this study was to determine the accuracy of a multiphasic gadolinium-enhanced three-dimensional (3D) fast spoiled gradient-recalled echo sequence alone in the detection and characterization of focal liver lesions compared with a comprehensive liver evaluation using multiphasic gadolinium-enhanced 3D fast spoiled gradient-recalled echo, T1-weighted, and fat-suppressed fast spin-echo T2-weighted sequences. MATERIALS AND METHODS. A retrospective review of abdominal MR imaging examinations in 61 patients was performed. All MR examinations included unenhanced spin-echo T1-weighted, unenhanced fat-suppressed fast spin-echo T2-weighted, and multiphasic gadolinium-enhanced 3D fast spoiled gradient-recalled echo sequences obtained during successive breath-holds. The liver was evaluated for focal lesions first with the 3D spoiled gradient-recalled echo sequences and then, during a separate sitting, with the T1- and T2-weighted sequences. The usefulness of each sequence in the detection and characterization of lesions was recorded. The gold standard for lesion detection and characterization was all three imaging sequences reviewed together. RESULTS. A total of 114 focal liver lesions were identified, 54 of which were simple cysts. The 3D spoiled gradient-recalled echo sequence alone detected 92 (81%) of the 114 lesions, and the T1- and T2-weighted sequences detected 95 (83%) of the 114 lesions. Of the 60 lesions that were not simple cysts, the 3D spoiled gradient-recalled echo sequence alone detected 58 (97%), and T1- and T2-weighted sequences detected 51 (85%). In 24% of the patients with lesions, the T1- and T2-weighted sequences were found to be helpful for the characterization of lesions. CONCLUSION. A multiphasic contrast-enhanced 3D fast spoiled gradient-recalled echo sequence alone detects most of the clinically relevant focal liver lesions. Additional liver examination using both unenhanced T1- and T2-weighted sequences is helpful for lesion characterization but increases the detection rate only minimally.