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

Objective: 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 (CNRs).

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 on 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 hemangiomas on any sequence.

Conclusions: Despite the statistically significant T1 and STIR increase 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.