title: Distinguishing hemangiomas from malignant solid hepatic lesions: a comparison of heavily T2-weighted images obtained before and after administration of gadoxetic acid.
abstract: OBJECTIVE
  To compare the use of heavily T2-weighted images obtained before and after administration of gadoxetic acid in differentiating hemangiomas from malignant solid hepatic lesions.
  
  
  METHODS
  Heavily T2-weighted images (TE=150 msec) were obtained for 70 patients (42 men and 28 women) with 74 focal hepatic lesions (25 hepatocellular carcinomas [HCC], 22 metastases, and 27 hemangiomas) ≤3 cm in diameter before and after gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI). Quantitative analysis was performed using receiver operating characteristic (ROC) curves with lesion-to-liver signal intensity difference-to-noise ratio (SDNR) on precontrast and postcontrast images. Qualitative analysis was also performed by two blinded reviewers.
  
  
  RESULTS
  The SDNR of the solid lesions was significantly higher on the postcontrast (1.66 ± 1.18) than on the precontrast (1.38 ± 1.07) images (P=0.0012), while the SDNR of hemangiomas was comparable for pre- and postcontrast images (P=0.8164). The best SDNR cutoff values for distinguishing solid lesions from hemangiomas were ≤1.85 (Az=0.948) for precontrast and ≤2.58 (Az=0.901) for postcontrast images (P=0.057). Reader performances for distinguishing hemangiomas from solid lesions were comparable between the precontrast (Az=0.975 and 0.970 for readers 1 and 2) and postcontrast (Az=0.977 and 0.972) images (P=0.899 and 0.946).
  
  
  CONCLUSIONS
  Heavily T2-weighted images obtained after administration of gadoxetic acid have a diagnostic capability comparable to precontrast images for differentiating between small hemangiomas and malignant solid lesions of the liver.
authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Sung Jun
authors: SJ
authors: Ahn
authors: Myeong-Jin
authors: MJ
authors: Kim
authors: Hye-Suk
authors: HS
authors: Hong
authors: Kyung Ah
authors: KA
authors: Kim
authors: Ho-Taek
authors: HT
authors: Song