Black-blood diffusion-weighted EPI acquisition of the liver with parallel imaging - Comparison with a standard T2-weighted sequence for detection of focal liver lesions

Objectives: To evaluate the performance of black-blood diffusion-weighted (DW)-EPI sequences with parallel imaging for the detection of focal liver lesions in comparison with a standard T2-weighted (T2-w) sequence. Materials and Methods: Twenty patients with known or suspected focal liver lesions underwent liver MRI using a DW-EPI sequence with a b-value of 50 S/mm(2) JR/TE 2200/50 ms) and a standard fat-saturated T2-w sequence (TR/TE 2800/107 ms) with 6-mm slice thickness on a 1.5-T MR1 system. Both sequences used parallel imaging with an acceleration factor of 2. Overall image quality and degree of artifacts were compared on a 5-point scale with 5 being the most desirable score. The detection rate and the level of confidence with regard to lesion detection were evaluated for both sequences in comparison to a contrast-enhanced (Gadolinium and SPIO) MR examination, which was used as the standard of reference. Results: The DW-EPI sequence showed significantly (P < 0.05) improved overall image quality (average score 4.15 vs. 3.63) and fewer artifacts (average score 4.2 vs. 3.5) in comparison with the T2-w sequence. The sensitivity for lesion detection was superior in the DW-EPI sequence (83% vs. 61%). The level of confidence in the detection of focal liver lesions was also superior for the DW-EPI sequence in comparison with the T2-w sequence (average score 3.9 vs. 3.2). Conclusions: DW-EPI sequences for liver-imaging are feasible with parallel imaging and show excellent image quality. They may contribute to more easy and confident lesion detection in comparison with T2-w sequences.