Small hepatocellular carcinoma versus small cavernous hemangioma: differentiation with MR imaging at 2.0 T.

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Abstract
Eighteen small hepatocellular carcinomas (HCCs) and 38 hemangiomas less than 5 cm in diameter were studied with magnetic resonance (MR) imaging at 2.0 T. Relatively T1-weighted spin-echo (SE) 500/30 (repetition time msec/echo time msec) images and proton-density 2,000/30 images showed nonspecific contrast-to-noise ratios (C/Ns) and intensity ratios in HCCs and hemangiomas. On T2-weighted 2,000/60, 90 , 120, 150, and 180 images, hemangiomas had significantly greater C/N and intensity ratios than HCCs (P < .05). The SE 2,000/180 sequence showed the greatest difference in tumor-liver intensity ratios between small HCCS and hemangiomas, followed by the SE 2,000/150 sequence, but there was no statistically significant difference between the two pulse sequences. However, the SE 2,000/180 sequences is limited in the number of sections obtainable for routine clinical liver imaging. The findings indicate that the SE 2,000/60 sequence is optimal for the detection of small HCCs and hemangiomas and that the SE 2,000/150 sequences is optimal for distinguishing small HCCs from hemangiomas at 2.0 T.

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