Differentiation between hepatic cavernous hemangioma and malignant tumor with T2-weighted MRI: comparison of fast spin-echo and breathhold fast spin-echo pulse sequences.
OBJECTIVE
The goal of our study was to compare a T2-weighted breathhold fast spin-echo (BHFSE) technique with T2-weighted nonbreathhold fast spin-echo (FSE) technique for characterizing cavernous hemangioma of the liver and differentiating this entity from malignant tumor.


METHODS
Eighteen patients with cavernous hemangiomas and 18 patients with malignant hepatic tumors were studied with T2-weighted MRI with a nonbreathhold FSE technique with and without fat suppression and with a BHFSE technique without fat suppression. Hepatic lesions were analyzed quantitatively using signal intensity (SI) and contrast-to-noise (C/N) ratio. In addition, images were qualitatively compared for accuracy in characterizing hepatic lesion.


RESULTS
Quantitatively, hemangioma had significantly higher SI and C/N ratios than did the malignant tumor on every pulse sequence (P < 0.01). Qualitatively, all malignant tumors were correctly categorized; differentiation between cavernous hemangioma and malignant tumor was impossible in three cases of cavernous hemangioma with the three pulse sequences (92% accuracy, 100% sensitivity, and 83% specificity).


CONCLUSIONS
T2-weighted FSE and BHFSE MRI shows comparable levels of accuracy for differentiating between hepatic cavernous hemangioma and malignant tumor. Because overlap may exist using quantitative measurement, morphologic patterns must be carefully analyzed, supporting that quantitative analysis and morphologic evaluation are complementary.
Soyer
P
P
Department of Radiology of Hôpital Foch, Suresnes, France.
Dufresne
A C
AC
Somveille
E
E
Lenormand
S
S
Scherrer
A
A
Rymer
R
R
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D013113:Spin Labels
D013113:Spin Labels