Hepatic hemangiomas and malignant tumors: Improved differentiation with heavily T2-weighted conventional spin-echo MR imaging

PURPOSE: To determine whether hemangiomas and malignant tumors can be better differentiated at 1.5-T magnetic resonance imaging with use of more heavily T2-weighted conventional spin-echo sequences. MATERIALS AND METHODS: Eighty-three patients with focal liver lesions (50 malignant tumors, 24 hemangiomas, nine cysts) larger than 1 cm were studied with a 3,000/80, 160 sequence (repetition time msec/echo time [TE] msec). T2 relaxation times and lesion/liver signal intensity ratios at TEs of 80 and 160 msec were measured. Receiver operating characteristic (ROC) analyses of expert readers and quantitative measures were performed. RESULTS: T2 relaxation times demonstrated the best performance in distinguishing hemangiomas from malignant tumors (area under ROC curve = .99 ± .01). Mean T2 times were 76 msec ± 11 for malignant tumors, 142 msec ± 40 for hemangiomas, and 341 msec ± 38 for cysts. A cutoff T2 value of 112 msec allowed discrimination between hemangiomas and malignant tumors with a 97% accuracy, 100% sensitivity, and 92% specificity. CONCLUSION: Hemangiomas and malignant tumors are better differentiated with use of T2 relaxation times obtained with a more heavily T2-weighted sequence.