Evaluation of turbo spin echo sequences for MRI of focal liver lesions at 0.5 T

To determine whether turbo spin echo (TSE) sequences can replace conventional T2-weighted spin echo (SE) sequences in MRI of the liver, 40 patients with focal liver lesions were imaged at 0.5 T. A T2-weighted SE sequences (TR/TE 1800/90 ms, number of signals averaged [NEX]=2, scan time=7:16 min), a TSE sequence (TR/TE 1800/90 ms, NEX=4, number of echos per excitation=13, echo spacing=12.9 ms, scan time=4:16 min) and a T1-weighted SE sequence (TR/TE 350/15 ms, NEX=2, scan time=4:21 min) were obtained and image quality, lesion detectability and lesion differentiation were evaluated qualitatively by subjective assessment using scores and quantitatively by lesion-liver contrast-to-noise (CNR) and tumour/liver signal intensity (SI) ratios. The image quality of the TSE sequence was substantially better compared with the T2-weighted SE sequence due to a reduction in motion artefacts and better delineation of anatomical details. Of a total of 158 visible lesions the T1-weighted SE, TSE, and T2-weighted SE sequences showed 91%, 81% and 65% of the lesions, respectively. Thus the TSE sequence depicted 24% (P< 0.001) more lesions than the T2-weighted SE sequence. In all types of pathology the lesion-liver CNR of the TSE sequence was significantly (P< 0.001) higher compared to the CNR of the T2-weighted SE sequence (+ 55–65%), indicating superior lesion conspicuity. Lesion characterization was equally good on the two T2-weighted sequences with no difference in the tumour/liver SI ratio. Using a criterion of tumour/liver SI ratio equal to or higher than 2, haemangiomas larger than 1 cm in diameter could be differentiated from other lesions with a sensitivity and specificity of 95% and 96%, respectively. Our results indicate that the TSE sequence is suitable for replacing the conventional T2-weighted SE sequence in MRI of focal liver lesions.