Usefulness of Postcontrast T2-Weighted Images in Shortening the Total Scan Time of a Gadoxectic Acid Enhanced MRI of the Liver: a Comparison between Precontrast and Postcontrast T2-Weighted Images

We evaluated the effects of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) on the overall image quality and lesion contrast of T2-weighted images (T2WI). We reviewed T2WI before and after Gd-EOB-DTPA enhancement in 50 patients with 41 focal liver lesions. Pre- and post-contrast T2WI were analyzed qualitatively and quantitatively. For the qualitative analysis, two abdominal radiologists, blinded to other findings in the study, retrospectively scored the image quality, lesion conspicuity, and artifacts. The quantitative analysis involved the measurement of the liver signal-to-noise ratio (SNR) and the lesion-to-liver contrast-to-noise ratio (CNR). Image quality and lesion conspicuity were not significantly different among the respiratory-triggered T2-weighted turbo spin-echo sequence (T2TSE), Half-fourier acquisition single-shot turbo spin-echo (HASTE) sequence, and breath-hold T2*- weighted gradient recalled-echo (GRE) sequences. However, there was a trend toward improved lesion conspicuity in post-contrast T2TSE. The quantitative analysis indicated that the SNR for post-contrast images was significantly higher than for pre-contrast images on T2TSE (p=0.04). No significant differences were seen in the CNR of focal lesions, but there was a trend towards an increase in the CNR for postcontrast T2WI of hepatocellular carcinoma. Compared to pre-contrast T2WI, post-contrast T2WI showed no handicap in the overall image quality and lesion contrast. Therefore, to shorten the total scan time during Gd-EOB-DTPA enhanced MRI, pre-contrast T2WI can be replaced by post-contrast T2WI