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Distinguishing Hepatic Metastases From Hemangiomas: Qualitative and Quantitative Diagnostic Performance Through Dual Echo Respiratory-Triggered Fast Spin Echo Magnetic Resonance Imaging

Kim, Young H MD, PhD*†; Saini, Sanjay MD; Blake, Michael A FFR(RCSI), FRCR*; Harisinghani, Mukesh MD*; Chiou, Yi-You MD§; Lee, Won Jin MD, PhD; Yu, Jeong-Sik MD; Hahn, Peter F MD, PhD*

Journal of Computer Assisted Tomography: September-October 2005 - Volume 29 - Issue 5 - p 571-579
doi: 10.1097/01.rct.0000172671.71446.33
Abdominal Imaging: Original Article

Objective: To determine the relative value of qualitative (reader opinion) and quantitative (values derived from dual echo T2 fast spin echo [FSE]) measures in distinguishing hepatic metastases from hemangiomas.

Methods: Forty-nine patients with hemangiomas and 23 with metastases were studied with dual echo respiratory-triggered FSE and dynamic 2-dimensional spoiled gradient echo (GRE) imaging. Lesion T2 was estimated from signal intensity ratios on the first and second echoes. Two experienced radiologists independently evaluated groups of images based on 5 separate qualitative measures: first echo FSE, second echo FSE, first and second echo FSE, dynamic GRE, and all images together.

Results: The mean calculated T2s were 226 ± 74 milliseconds for hemangiomas and 105 ± 22 milliseconds for metastases (P < 0.001). A T2 cutoff of 130 milliseconds distinguished metastases from hemangiomas with a sensitivity of 94%, specificity of 91%, and accuracy of nearly 94%. There was no significant difference between the best quantitative measure and the best qualitative measure for either reader.

Conclusion: Liver lesion T2 relaxation times calculated from dual echo FSE images provide information useful in discriminating metastases from hemangiomas, as does reader opinion.

From the *Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; †Department of Radiology, Umass Memorial Health Care, University of Massachusetts Medical School, Worchester, MA; ‡Department of Radiology, Emory University Hospital, Emory University School of Medicine, Atlanta, GA; §Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; ∥Department of Preventive Medicine, Korea University College of Medicine, Sungbuk-ku, Seoul, Korea; and ¶Department of Diagnostic Radiology, YongDong Severance Hospital, Yonsei University College of Medicine, Gangnam-Gu, Seoul, South Korea.

Received for publication February 24, 2005; accepted May 25, 2005.

Reprints: Peter F. Hahn, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA 02114 (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.