Differentiation between hepatic cyst and hemangioma: Additive value of breath‐hold, multisection fluid‐attenuated inversion‐recovery magnetic resonance imaging using half‐Fourier acquisition single‐shot turbo‐spin‐echo sequence

Abstract Purpose To evaluate the additive value of breath‐hold, multisection fluid‐attenuated inversion‐recovery (FLAIR) magnetic resonance imaging (MRI) using half‐Fourier acquisition single‐shot turbo‐spin‐echo (HASTE) sequence as supplements to moderately and heavily T2‐weighted fast‐spin‐echo (FSE) sequences in differentiating hepatic cyst from hemangioma. Materials and Methods A total of 183 lesions (127 hepatic cysts, 56 hepatic hemangiomas) in 117 patients were evaluated in this study. Three radiologists independently reviewed FLAIR MR images using a HASTE sequence and T2‐weighted FSE MR images. Each radiologist used a five‐point scale to rate his confidence in determination of hepatic cyst and hemangioma. Results All three reviewers were significantly better able to differentiate hepatic cyst from hepatic hemangioma with the combination of FLAIR imaging using HASTE and moderately and heavily T2‐weighted FSE images (area under the receiver operating characteristic (ROC) curve, 0.99 for each reader) than with moderately and heavily T2‐weighted FSE images alone (0.82–0.93; P < 0.05). FLAIR‐HASTE imaging in addition to T2‐weighted FSE sequences improved the diagnostic performance, including the sensitivity, specificity, accuracy, and confident diagnosis in the differentiation between hepatic hemangiomas and cysts. Conclusion FLAIR‐HASTE imaging is useful for distinguishing hepatic hemangioma from hepatic cyst without the use of contrast‐enhanced MR images. J. Magn. Reson. Imaging 2005;21:29–36. © 2004 Wiley‐Liss, Inc.