Conspicuity of liver-hemangiomas: Short tau inversion recovery, T1, and T2 imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid

Purpose: To compare conspicuity of liver hemangiomas on STIR. T1-weighted, and T2-weighted magnetic resonance (MR) images before and after administration of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid. (GD-EOB-DTPA) (hepatocellular contrast agent), using contrast-to-noise ratios (CNR). Materials and Methods: Thirteen hemangiomas were imaged using breath-hold gradient echo (GRE) T1, fat-saturated turbo spin echo (TSE)-T2, and short tau inversion recovery (STIR) sequences. Background noise and signal-to-noise ratios (SNRs) for liver and hemangioma, along with CNR for normal liver and hemangioma, were measured in each sequence before and after administration of Gd-EOB-DTPA. Hemangioma conspicuity was also evaluated qualitatively. Results: After Gd-EOB-DTPA administration, the quantitative liver SNR-decreased 54% on STIR, increased 45% on T1-weighted images, and increased 14.5% on TSE-T2-weighted images. The CNR for liver and hemangioma increased 50% on STIR images (P < 0.0001), increased 46% on T1-weighted-imaging (P = 0.0033), and increased 22% on TSE-T2-weighted MR-imaging (MRI) (P = 0.0083). After contrast, the CNR for TSE-T2 images was greater than those for both the T1 and STIR images (P < 0.0001 for both). Qualitatively, signal change was visually apparent in the liver on T1 and STIR, but not on T2 images or in the hemamgiomas on any sequence. Conclusion: Despite the statistically significant T1 and STIR incvrease in CNR, liver hemangiomas were most conspicuous on TSE-T2 images after Gd-EOB-DTPA. This pilot study with hemangiomas highlights the newly recognized potential benefit of TSE-T2 imaging with hepatocellular contrast.